Hangaard Stine, Helle Tina, Nielsen Carl, Hejlesen Ole K
Aalborg University, Department of Health Science and Technology, Medical Informatics Group, Fredrik Bajers Vej 7C, 9220 Aalborg Ø, Denmark.
University College of Northern Denmark, Department of Research and Development, Selma Lagerløfs Vej 2, 9220 Aalborg Ø, Denmark.
Respir Med. 2017 Aug;129:63-84. doi: 10.1016/j.rmed.2017.05.015. Epub 2017 May 29.
Chronic obstructive pulmonary disease (COPD) has serious implications at both the individual and the societal level. It is crucial that COPD is diagnosed correctly to ensure provision of the right treatment. However, the current diagnostic procedures may lead to misdiagnosis.
The aim of this scoping review was to disseminate knowledge about potential causes of misdiagnosis of COPD.
A systematic, comprehensive search was performed in PubMed, Embase and Cinahl.
A thorough review produced a sample of 73 articles. The synthesis revealed five potential causes of misdiagnosis of COPD, including: the threshold for defining COPD (n = 36), errors made in primary care (n = 15), errors linked to the spirometry test (n = 13), differential diagnoses (n = 10), and patient-related factors (n = 8).
The causes of misdiagnosis of COPD are attributable mainly to spirometry and to the healthcare professional performing the diagnostic assessment. With a view to limiting misdiagnosis of COPD, future research should help clarify strategies for alternative objective tests for determining if a patient has COPD and explore how to better support primary care in the diagnosing of COPD.
慢性阻塞性肺疾病（COPD）在个人和社会层面均具有严重影响。正确诊断COPD以确保提供恰当治疗至关重要。然而，当前的诊断程序可能导致误诊。
本范围综述的目的是传播有关COPD误诊潜在原因的知识。
在PubMed、Embase和Cinahl中进行了系统、全面的检索。
全面综述产生了73篇文章的样本。综合分析揭示了COPD误诊的五个潜在原因，包括：COPD定义阈值（n = 36）、初级保健中的错误（n = 15）、与肺量计测试相关的错误（n = 13）、鉴别诊断（n = 10）以及患者相关因素（n = 8）。
COPD误诊的原因主要归因于肺量计测试以及进行诊断评估的医疗专业人员。为了限制COPD的误诊，未来的研究应有助于阐明用于确定患者是否患有COPD的替代客观测试策略，并探索如何更好地支持初级保健对COPD的诊断。
