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Family Practice Advance Access published online on May 7, 2009
Family Practice, doi:10.1093/fampra/cmp026
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© The Author 2009. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org.

The diagnostic value of history and physical examination for COPD in suspected or known cases: a systematic review

Berna DL Broekhuizen, Alfred PE Sachs, Rimke Oostvogels, Arno W Hoes, Theo JM Verheij and Karel GM Moons

Department of General Practice, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands

Correspondence to Berna DL Broekhuizen, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, PO Box 85500, 3508 GA Utrecht, The Netherlands; E-mail: b.d.l.broekhuizen{at}umcutrecht.nl

Received 18 September 2008; Revised 26 February 2009; Accepted 20 March 2009.


  Abstract

Background. According to current guidelines, spirometry should be performed in patients suspected of chronic obstructive pulmonary disease (COPD) by the results of history taking and physical examination. However, little is known about the diagnostic value of patient history and physical examination for COPD.

Objectives. To review the existing evidence on the diagnostic value of history taking and physical examination in recognizing COPD in patients suspected of COPD.

Methods. A systematic literature search was performed in electronic medical databases. Studies were included after using defined inclusion and exclusion criteria and judged on their methodological quality by using the Quality Assessment of Diagnostic Accuracy Studies criteria. A formal meta-analysis was not performed because all studied items of history and physical examination were investigated in only in a maximum of three studies.

Results. Six studies were included. The history items dyspnoea, wheezing, previous consultation for wheezing or cough, self-reported COPD, age and smoking and the physical examination items wheezing, forced expiratory time, laryngeal height and prolonged expiration were found to have diagnostic value for COPD. These items were studied in maximally three studies and study population studies were heterogenic. The reference test for COPD in five of the six studies concerned obstructive lung disease in general and not COPD.

Conclusion. There is insufficient evidence to assess the value of history taking and physical examination for diagnosing COPD.

Keywords. COPD, diagnosis, patient history, physical examination.

Broekhuizen BDL, Sachs APE, Oostvogels R, Hoes AW, Verheij TJM and Moons KGM. The diagnostic value of history and physical examination for COPD in suspected or known cases: a systematic review. Family Practice 2009; Pages 1–9 of 9.


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The diagnostic value of history and physical examination for COPD
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Re: The diagnostic value of history and physical examination for COPD
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