INSERM, U707, F-75012 Paris, France.
BMC Med. 2011 Jan 18;9:7. doi: 10.1186/1741-7015-9-7.
Chronic obstructive pulmonary disease (COPD) is predicted to become a major cause of death worldwide. Studies on the variability in the estimates of key epidemiological parameters of COPD may contribute to better assessment of the burden of this disease and to helpful guidance for future research and public policies. In the present study, we examined differences in the main epidemiological characteristics of COPD derived from studies across countries of the European Union, focusing on prevalence, severity, frequency of exacerbations and mortality, as well as on differences between the studies' methods.
This systematic review was based on a search for the relevant literature in the Science Citation Index database via the Web of Science and on COPD mortality rates issued from national statistics. Analysis was finally based on 65 articles and Eurostat COPD mortality data for 21 European countries.
Epidemiological characteristics of COPD varied widely from country to country. For example, prevalence estimates ranged between 2.1% and 26.1%, depending on the country, the age group and the methods used. Likewise, COPD mortality rates ranged from 7.2 to 36.1 per 10(5) inhabitants. The methods used to estimate these epidemiological parameters were highly variable in terms of the definition of COPD, severity scales, methods of investigation and target populations. Nevertheless, to a large extent, several recent international guidelines or research initiatives, such as GOLD, BOLD or PLATINO, have boosted a substantial standardization of methodology in data collection and have resulted in the availability of more comparable epidemiological estimates across countries. On the basis of such standardization, severity estimates as well as prevalence estimates present much less variation across countries. The contribution of these recent guidelines and initiatives is outlined, as are the problems remaining in arriving at more accurate COPD epidemiological estimates across European countries.
The accuracy of COPD epidemiological parameters is important for guiding decision making with regard to preventive measures, interventions and patient management in various health care systems. Therefore, the recent initiatives for standardizing data collection should be enhanced to result in COPD epidemiological estimates of improved quality. Moreover, establishing international guidelines for reporting research on COPD may also constitute a major contribution.
慢性阻塞性肺疾病（COPD）预计将成为全球主要的死亡原因。研究 COPD 关键流行病学参数的变异性可能有助于更好地评估该疾病的负担，并为未来的研究和公共政策提供有益的指导。本研究通过 Web of Science 中的科学引文索引数据库对欧盟各国的 COPD 主要流行病学特征进行了研究，重点关注患病率、严重程度、加重频率和死亡率，以及研究方法之间的差异。
本系统评价基于在科学引文索引数据库中通过 Web of Science 搜索相关文献，以及对来自国家统计数据的 COPD 死亡率进行分析。最终分析基于 65 篇文章和 21 个欧洲国家的 Eurostat COPD 死亡率数据。
COPD 的流行病学特征在国家之间存在很大差异。例如，患病率估计值因国家、年龄组和使用的方法而异，范围在 2.1%至 26.1%之间。同样，COPD 死亡率在每 105 居民 7.2 至 36.1 之间。用于估计这些流行病学参数的方法在 COPD 的定义、严重程度量表、调查方法和目标人群方面存在很大差异。然而，在很大程度上，最近的几项国际指南或研究倡议，如 GOLD、BOLD 或 PLATINO，促进了数据收集方法的大量标准化，并导致了各国之间更可比的流行病学估计值。基于这种标准化，严重程度估计值以及患病率估计值在国家之间的差异要小得多。本文概述了这些最新指南和倡议的贡献，以及在达成更准确的欧洲国家 COPD 流行病学估计值方面仍然存在的问题。
COPD 流行病学参数的准确性对于指导各种医疗保健系统中预防措施、干预措施和患者管理的决策非常重要。因此，应加强最近的数据收集标准化倡议，以提高 COPD 流行病学估计值的质量。此外，制定关于 COPD 研究报告的国际指南也可能是一项重大贡献。
