Jove
Visualize
Contact Us
JoVE
x logofacebook logolinkedin logoyoutube logo
ABOUT JoVE
OverviewLeadershipBlogJoVE Help Center
AUTHORS
Publishing ProcessEditorial BoardScope & PoliciesPeer ReviewFAQSubmit
LIBRARIANS
TestimonialsSubscriptionsAccessResourcesLibrary Advisory BoardFAQ
RESEARCH
JoVE JournalMethods CollectionsJoVE Encyclopedia of ExperimentsArchive
EDUCATION
JoVE CoreJoVE BusinessJoVE Science EducationJoVE Lab ManualFaculty Resource CenterFaculty Site
Terms & Conditions of Use
Privacy Policy
Policies

Related Experiment Videos

Utilization in COPD: patient characteristics and diagnostic evaluation.

D W Mapel1, M A Picchi, J S Hurley

  • 1Epidemiology and Cancer Control Program, University of New Mexico Health Sciences Center, Albuquerque, NM 87131-5306, USA. dmapel@salud.unm.edu

Chest
|June 10, 2000
PubMed
Summary

Related Concept Videos

You might also read

Related Articles

Articles linked to this work by shared authors, journal, and citation graph.

Sort by
Same author

Person-centred, integrated and pro-active care for multi-morbid elderly with advanced care needs: a propensity score-matched controlled trial.

BMC health services research·2019
Same author

Economic evaluations of fluticasone-propionate/salmeterol combination therapy for chronic obstructive pulmonary disease: a review of published studies.

Expert review of pharmacoeconomics & outcomes research·2016
Same author

Global identification of genes targeted by DNMT3b for epigenetic silencing in lung cancer.

Oncogene·2014
Same author

Aerosolised 5-azacytidine suppresses tumour growth and reprogrammes the epigenome in an orthotopic lung cancer model.

British journal of cancer·2013
Same author

Development and validation of an instrument to measure the impact of genetic testing on self-concept in Lynch syndrome.

Clinical genetics·2011
Same author

Clinical outcomes with unfractionated heparin or low-molecular-weight heparin as bridging therapy in patients on long-term oral anticoagulants: the REGIMEN registry.

Journal of thrombosis and haemostasis : JTH·2006

This study compared COPD patients from two health systems to understand differences in diagnosis and treatment. Researchers found that patients in a university-affiliated center were younger, used more home oxygen, and had fewer chronic conditions than those in an HMO. Smoking was still common in both groups, with about half continuing to smoke. Spirometry, a test to confirm COPD, was rarely documented in patient records. These findings suggest that COPD diagnosis often relies on symptoms and smoking history rather than objective testing. The authors suggest that better use of spirometry and smoking cessation efforts could improve COPD care in these systems.

Area of Science:

  • Respiratory medicine
  • Chronic disease management
  • Health services research

Background:

Current diagnostic and treatment practices for COPD remain unclear in many health systems. Prior research has shown that COPD is often diagnosed based on symptoms alone, without objective testing. No prior work had resolved how frequently spirometry is used in real-world settings. This gap motivated a study comparing diagnostic approaches in two different health systems. One system was a regional HMO, and the other was a university-affiliated medical center. These systems differ in patient demographics and care delivery models. Understanding these differences helps identify areas for improvement in COPD care. Smoking remains a key risk factor, yet its impact on COPD management is not fully understood. The need for better diagnostic confirmation through spirometry has been suggested but not widely implemented.

Purpose Of The Study:

The aim of this study was to compare COPD patient characteristics and diagnostic practices in two distinct health-care systems. The researchers sought to determine if differences exist in patient demographics and diagnostic testing use. They focused on spirometry documentation as a key diagnostic tool. Smoking status was also examined as a common risk factor. The study aimed to identify gaps in COPD diagnosis and treatment. By analyzing data from administrative databases, the researchers could assess real-world practices. Their goal was to inform strategies for improving COPD care. The findings may suggest ways to increase diagnostic accuracy and smoking cessation efforts.

Keywords:
COPD diagnosishealth system differencesspirometry useCOPD patient characteristics

Frequently Asked Questions

The study found that COPD patients in a university-affiliated center were younger, used more home oxygen, and had fewer chronic conditions compared to those in an HMO.

Researchers randomly selected 200 COPD patients from each system using administrative databases based on discharge diagnoses.

Spirometry confirms airflow obstruction, but the study found only 38–42% of patients had documented results, suggesting limited use in real-world practice.

Smoking was a common risk factor, with about half of patients in both systems still smoking, highlighting the need for smoking cessation efforts.

Related Experiment Videos

Main Methods:

The study used a cross-sectional survey design to collect data from two health systems. One system was a regional HMO with 174,484 members, and the other was a university-affiliated county medical center. Researchers randomly selected 200 COPD patients from each system using administrative databases. Patient records were reviewed for clinical characteristics and diagnostic evaluations. Age, smoking status, and chronic conditions were compared between the two groups. Spirometry documentation was assessed as a key diagnostic measure. Home oxygen use and other treatment indicators were also recorded. The analysis focused on differences in patient profiles and diagnostic practices.

Main Results:

Patients in the university-affiliated medical center were younger, with a mean age of 59.3 years compared to 66.9 in the HMO. They were more likely to use home oxygen (33% vs 20%) and had fewer chronic conditions (3.1 vs 3.7). Smoking was still prevalent in both groups, with about half continuing to smoke. Only 38% of HMO patients and 42% of university-affiliated patients had documented spirometry results. These findings suggest limited use of diagnostic testing in COPD management. The diagnosis in most cases relied on symptoms and smoking history. The lack of spirometry documentation indicates a gap in confirming COPD diagnoses. These results highlight the need for improved diagnostic practices.

Conclusions:

The study found significant differences in COPD patient characteristics between two health systems. Younger patients and those with fewer chronic conditions were more common in the university-affiliated center. Smoking remained a shared risk factor, with similar prevalence in both groups. Spirometry use was low overall, suggesting a gap in diagnostic confirmation. The authors propose that COPD diagnosis often relies on symptoms and smoking history. They suggest that increased emphasis on smoking cessation is needed. More effective use of spirometry could improve diagnostic accuracy. These findings may inform strategies to enhance COPD management in health systems.

Only 38% of HMO patients and 42% of university-affiliated patients had spirometry results in their medical records.

The authors propose that increased emphasis on smoking cessation and more effective use of spirometry could improve COPD management in health systems.