Will Recommendation Against COPD Screening Undermine Early Diagnosis?

by Amanda Conschafter, blog editor

Screening questionnaires offers a simple, inexpensive way to proactively identify and educate patients at risk for COPD (chronic obstructive pulmonary disease). The disease affects more than 12 million Americans, many of whom are not aware they have it. Yet under a new recommendation from the U.S. Preventive Services Task Force, COPD screening questionnaires may become obsolete. The move would eliminate crucial opportunities to diagnose asymptomatic patients and remove the impetus for potentially life-saving conversations with one’s physician.

The COPD Screening Draft Recommendation Statement assesses the use of validated screening questionnaires along with spirometry screening, a more extensive in-office procedure. The task force finds no “net benefit” to using both methods.

However, the task force did not consider the effectiveness of using only questionnaires. Therefore, in a letter to the U.S. Preventive Services Task Force earlier this month, the Alliance for Patient Access suggested splitting the recommendation—addressing the issue of questionnaire use separately from the topic of spirometry.

Assessing the two methods independently of one another could encourage continued use of screening questionnaires, which AfPA described as “a critical – and low-cost – tool used by physicians to encourage a conversation that may lead to early diagnosis of COPD and potentially better patient outcomes.”

If finalized, however, the recommendation would virtually eliminate the short, self-administered questionnaires now used in clinical settings throughout the country. Such questionnaires currently aid physicians in identifying patients who need follow-up and further testing, which can help especially with patients unfamiliar with COPD symptoms.

COPD is the fourth leading cause of death in the United States and a significant source of chronic disability worldwide. Yet undiagnosed COPD is still a common problem. Estimates suggest that, for every COPD patient who has been diagnosed, two or more patients go undiagnosed. Should screening questionnaires go by the wayside, diagnosing these patients could become still less likely.


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