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Undiagnosed and misdiagnosed chronic obstructive pulmonary disease: Data from the BOLD Australia study

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journal contribution
posted on 2023-05-21, 02:41 authored by Petrie, K, Toelle, BG, Wood-Baker, R, Maguire, GP, James, AL, Hunter, M, Johns, DP, Marks, GB, George, J, Abramson, MJ

Purpose: Spirometry is necessary to confirm COPD, but many patients are diagnosed based on clinical presentation and/or chest x-ray. There are also those who do not present to primary care for case finding and remain undiagnosed. We aimed to identify: (a) factors that are associated with undiagnosed COPD; and (b) factors that are associated with a potential misdiagnosis of COPD.

Patients and methods: This analysis used data from the Burden of Obstructive Lung Disease (BOLD), a cross-sectional study of community dwelling adults randomly selected from six study sites, chosen to provide a representative sample of the Australian population (n= 3357). Participants were grouped by COPD diagnostic criteria based on spirometry and self-reported diagnosis. Odds ratios for predictors of undiagnosed and misdiagnosed were estimated using logistic regression.

Results: Of the BOLD Australia sample, 1.8% had confirmed COPD, of whom only half self-reported a diagnosis of COPD. A further 6.9% probably had COPD, but were undiagnosed. The priority target population for case finding of undiagnosed COPD was aged ≥60 years (particularly those ≥75 years), with wheezing, shortness of breath and a body mass index (BMI) <25kg/m2. The priority target population for identifying and reviewing misdiagnosed COPD was aged <60 years, female, with no wheezing and a BMI ≥25kg/m2.

Conclusion: Challenges continue in accurately diagnosing COPD and greater efforts are needed to identify undiagnosed and misdiagnosed individuals to ensure an accurate diagnosis and the initiation of appropriate management in order to reduce the burden of COPD.


Publication title

International Journal of COPD








Tasmanian School of Medicine


DOVE Medical Press

Place of publication

New Zealand

Rights statement

Copyright 2021 Petrie et al. Licensed under Creative Commons Attribution-NonCommercial 3.0 Unported (CC BY-NC 3.0)

Repository Status

  • Open

Socio-economic Objectives

Diagnosis of human diseases and conditions

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