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Lee, Yoo, Park, Kim, Yoon, Kim, Lee, Park, Park, Hwang, Jung, Yoo, Park, Lee, Huh, Oh, Lim, Jung, Kim, Kim, Rhee, Kim, Kim, Yoon, and Lee: Early Diagnosis and Management of Chronic Obstructive Pulmonary Disease
Review
Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases 2011; 70(4): 293-300.

Published online: 30 April 2011

DOI: https://doi.org/10.4046/trd.2011.70.4.293

Early Diagnosis and Management of Chronic Obstructive Pulmonary Disease

Sei Won Lee, M.D.1, Jee-Hong Yoo, M.D.2, Myung Jae Park, M.D.2, Eun Kyung Kim, M.D.3, Ho Il Yoon, M.D.1, Deog Kyeom Kim, M.D.4, Chang Hoon Lee, M.D.4, Yong Bum Park, M.D.5, Joo Hun Park, M.D.6, Yong Il Hwang, M.D.7, Ki-Suck Jung, M.D.7, Kwang Ha Yoo, M.D.8, Hye Yoon Park, M.D.9, Jae Seung Lee, M.D.10, Jin-Won Huh, M.D.10, Yeon Mok Oh, M.D.10, Seong Yong Lim, M.D.11, Ji Ye Jung, M.D.12, Young Sam Kim, M.D.12, Hui Jung Kim, M.D.13, Chin Kook Rhee, M.D.14, Young Kyoon Kim, M.D.14, Jin Woo Kim, M.D.15, Hyoung Kyu Yoon, M.D.16, Sang-Do Lee, M.D.10

1Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.

2Department of Internal Medicine, Kyung Hee University Hospital, Seoul, Korea.

3Department of Internal Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea.

4Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea.

5Department of Internal Medicine, Kang-Dong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.

6Department of Pulmonary and Critical Care Medicine, Ajou University School of Medicine, Suwon, Korea.

7Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea.

8Department of Internal Medicine, Konkuk University College of Medicine, Seoul, Korea.

9Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

10Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

11Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.

12Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.

13Department of Internal Medicine, Wonkwang University Sanbon Hospital, Wonkwang University College of Medicine, Gunpo, Korea.

14Department of Internal Medicine, Seoul St. Mary's Hospital, Seoul, Korea.

15Department of Internal Medicine, Uijeongbu St. Mary's Hospital, Uijeongbu, Korea.

16Department of Internal Medicine, Yeouido St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea.

Address for correspondence: Sang-Do Lee, M.D. Department of Pulmonary and Critical Care Medicine, and Clinical Research Center for Chronic Obstructive Airway Diseases, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Pungnap-dong, Sonpa-gu, Seoul 138-736, Korea. Phone: 82-2-3010-3140, Fax: 82-2-3010-6968, sdlee@amc.seoul.kr

Received 11 February 2011       Accepted 13 April 2011

Copyright © 2011. The Korean Academy of Tuberculosis and Respiratory Diseases. All rights reserved.

Abstract

Chronic obstructive pulmonary disease (COPD) is a substantially under-diagnosed disorder, and the diagnosis is usually delayed until the disease is advanced. However, the benefit of early diagnosis is not yet clear, and there are no guidelines in Korea for doing early diagnosis. This review highlights several issues regarding early diagnosis of COPD. On the basis of several lines of evidence, early diagnosis seems quite necessary and beneficial to patients. Early diagnosis can be approached by several methods, but it should be confirmed by quality-controlled spirometry. Compared with its potential benefit, the adverse effects of spirometry or pharmacotherapy appear relatively small. Although it is difficult to evaluate the benefit of early diagnosis by well-designed trials, several lines of evidence suggest that we should try to diagnose and manage patients with COPD at early stages of the disease.

Keywords: Pulmonary Disease, Chronic Obstructive, Early Diagnosis, Spirometry

Figures and Tables

Figure 1
Schematic frame for early diagnosis of COPD in Korea. COPD: chronic obstructive pulmonary disease; FEV1: forced expiratory volume in one second; FVC: forced vital capacity; LLN: lower limit of normal.
trd-70-293-g001
Table 1
Pros and cons for the early diagnosis of COPD
trd-70-293-i001

COPD: chronic obstructive pulmonary disease.

Table 2
Smoking amount as the risk factor of COPD in Korea
trd-70-293-i002

The data from KNHANES IV in year 2008 were used (unpublished data). COPD was defined by prebronchodilator FEV1/FVC less than 0.70.

*Odds ratios are adjusted by age, sex, residential status, education and income level.

COPD: chronic obstructive pulmonary disease; OR: odds ratio; CI: confidence interval; PY: pack year; KNHANES: Korean National Health and Nutritional Examination Survey.

Acknowledgements

This study was supported by a grant of the Korea Healthcare technology R&D Project, Ministry for Health and Welfare, Republic of Korea (A102065).

Notes

All institutions which participated in this study are designated clinical research center for chronic obstructive airway diseases by Ministry of Health and Welfare.

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