A follow-up study (MARKO) supports the need to change the diagnostic criteria for COPD

Abstract

Introduction: There is a significant dispute about the diagnostic criteria for COPD. Global Lung Initiative (GLI) found a significant under- and overestimation of diagnosed COPD based on GOLD criteria (FEV 1 /FVC Aim: The aim of this research was to compare the ability of exhaled breath temperature (EBT) to predict COPD development in smokers at risk using two different diagnostic criteria. Materials and methods: The study was a part of a multicenter prospective cohort study in current smokers (N=140, both sex, 40-65 years, ≥20 pack-years) with no prior diagnosis of COPD. Diagnostic workup: history, physical, quality of life, haematology and highly sensitive CRP, EBT before and after smoking a cigarette, lung function with bronchodilator test and 6-minute walk test. Patients were reassessed after 2 years. COPD was diagnosed based on GOLD and lower level of normal (LLN) lung function criteria (GLI). Utility of EBT for disease progression was analyzed using receiver operator curve (ROC) analysis and logistic regression analysis. Results: EBT at initial visit was significantly predictive for disease progression (newly diagnosed COPD and disease progression) after 2 years (p Conclusion: We found that EBT as susceptibility marker to a cigarette smoke for the prediction of future development and progression of COPD gives significantly better signal when using GLI criteria for diagnosing COPD. ClinicalTrials.gov Identifier: NCT01550679 Supported by an unrestricted grant by GlaxoSmithKline (GSK eTrack number CRT114338).