Dr Surya Kant
Today (19 November) is World COPD Day. Organized by the Global Initiative for Chronic Obstructive Lung Disease (GOLD) annually since its inception in 2002, this day aims to raise awareness about Chronic Obstructive Pulmonary Disease COPD highlighting a special theme every year. The theme for this year is “Short of Breath, Think COPD” recognizing the need for timely evaluation and diagnosis.
COPD is a “common preventable, and treatable disease” (1) yet it still remains undiagnosed despite the enormous burden of the disease. Under-diagnosis and misdiagnosis can result in patients receiving either no treatment or incorrect treatment culminating in significant morbidity and mortality. Symptoms like cough and dyspnea are often ignored by the patients initially.
The gold-standard tool to diagnose COPD is spirometry. However, limited access to this confirmatory test in resource-limited settings, coupled with low awareness, lack of targeted screening programs, often prevents timely and accurate diagnosis.
According to a systematic review published in the journal Advances in Respiratory Medicine, portable spirometers are valuable aids for the early diagnosis of COPD. Although they detected a slightly lower prevalence of COPD compared to conventional spirometry, they nonetheless enable bedside diagnosis, making it more convenient to find hitherto undetected cases of COPD (2).
The study conducted by Piotr Jankowski from the Dept. of Internal Medicine, Pulmonary Diseases and Allergy, Medical University of Warsaw and colleagues addressed two key objectives. One, to assess the prevalence of COPD in high-risk patients using a portable spirometer and compare it with conventional, on-site spirometry data. Second, to evaluate a proactive approach to identify COPD in high-risk individuals.
After scrutinizing over 8000 studies on COPD related to targeted screening and diagnosis with portable and conventional spirometers obtained from Cochrane, PubMed, and Embase databases, 28 studies were included in the review.
Across the selected studies, the prevalence of COPD identified by portable spirometry averaged 20.27%, which was slightly lower than the 24.67% detected using conventional laboratory-based spirometers. In 11 studies, postbronchodilator tests were performed with portable spirometers, which confirmed an irreversible airflow limitation, particularly in smokers, allowing for bedside diagnosis of COPD.
This study demonstrates the feasibility of spirometry using portable spirometers for targeted screening of high risk individuals rather than the general population. Their accessibility, ease of use and cost-effectiveness make portable spirometry a very useful diagnostic tool in primary care and resource-constrained settings, for proactive early COPD detection.
References
1. Global Initiative for Chronic Obstructive Lung Disease. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. 2025 Report.
2. Jankowski P, et al. How to enhance the diagnosis of early stages of chronic obstructive pulmonary disease (COPD)? The role of mobile spirometry in COPD screening and diagnosis-a systematic review. Adv Respir Med. 2024 Mar 27;92(2):158-174. doi: 10.3390/arm92020018.
Dr Surya Kant is Professor and Head, Dept. of Respiratory Medicine, KGMU, UP, Lucknow. National Vice Chairman IMA-AMS