PT  - JOURNAL ARTICLE
AU  - Berna DL Broekhuizen
AU  - Alfred PE Sachs
AU  - Arno W Hoes
AU  - Karel GM Moons
AU  - Jan WK van den Berg
AU  - Willem H Dalinghaus
AU  - Ernst Lammers
AU  - Theo JM Verheij
TI  - Undetected chronic obstructive pulmonary disease and asthma in people over 50 years with persistent cough
AID  - 10.3399/bjgp10X514738
DP  - 2010 Jul 01
TA  - British Journal of General Practice
PG  - 489--494
VI  - 60
IP  - 576
4099  - http://bjgp.org/content/60/576/489.short
4100  - http://bjgp.org/content/60/576/489.full
SO  - Br J Gen Pract2010 Jul 01; 60
AB  - Background Chronic obstructive pulmonary disease (COPD) and asthma are underdiagnosed in primary care.Aim To determine how often COPD or asthma are present in middle-aged and older patients who consult their GP for persistent cough.Design of study A cross-sectional study in 353 patients older than 50 years, visiting their GP for persistent cough and not known to have COPD or asthma.Setting General practice in the Netherlands.Method All participants underwent extensive diagnostic work-up, including symptoms, signs, spirometry, and body plethysmography. All results were studied by an expert panel to diagnose or exclude COPD and/or asthma. The reproducibility of the panel diagnosis was assessed by calculation of Cohen's κ statistic in a sample of 41 participants.Results Of the 353 participants, 102 (29%, 95% confidence interval [CI] = 24 to 34%) were diagnosed with COPD. In 14 of these 102 participants, both COPD and asthma were diagnosed (4%, 95% CI = 2 to 7%). Asthma (without COPD) was diagnosed in 23 (7%, 95% CI = 4 to 10%) participants. Mean duration of cough was 93 days (median 40 days). The reproducibility of the expert panel was good (Cohen's κ = 0.90).Conclusion In patients aged over 50 years who consult their GP for persistent cough, undetected COPD or asthma is frequently present.