Diagnosis of asthma, CB, and emphysema

In the United States, a more specific criterion was used (GOLD stage IB [ie, FEV1/FVC ratio < 0.7 and FEV1 < 80% predicted]), whereas in Italy a more sensitive criterion (ie, GOLD criterion for stage 1 to 4 disease, without considering FEV1 percent predicted) was used. Indeed, we believe that it is more informative to provide sensitive data to estimate the burden of COPD in the population, in view of the underutilization of spirometry.

The external validity of our study is enhanced by the fact that in our populations the asthma-only group also comprised the largest proportion of OLD patients, and it decreased with increasing age, as in the study by Soriano et al. It is important to point out that our data, like those in NHANES III, were collected before or immediately after the publication of the Global Initiative for Asthma guidelines on asthma, whereas the UK General Practice Research Viagra Australia Pharmacy Database provided data that were collected several years after. Thus, it would be helpful to perform similar epidemiologic studies in order to assess the possible influence of the updated GOLD guidelines on COPD diagnosis, and of the updated Global Initiative for Asthma guidelines on asthma diagnosis.

The fact that the concomitant diagnosis of asthma, CB, and emphysema is common among OLD patients from the general population, particularly in adults aged > 50 years, also has been demonstrated by researchers who have not attempted to develop a proportional Venn diagram. An interesting study on the early detection of COPD or asthma in a random sample from the general population aged 25 to 70 years has been carried out in 10 general practices located in the eastern part of the Netherlands within the framework of the Detection, Intervention, and Monitoring Program of COPD and Asthma program. A total of 19.4% of the general population showed mild objective signs of COPD or asthma. Recently, it has been demonstrated in a cohort of 1,052 subjects with a1-antitrypsin deficiency, that asthma was present in 21% of the cohort and attacks of wheezing were reported in 66%.

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