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Will Recommendations against Spirometry Make Chronic Obstructive Pulmonary Disease Harder to Treat?
- Thomas L. Petty, MD; and
- David M. Mannino, MD
- From the University of Colorado, Denver, CO 80220, and University of Kentucky College of Public Health, Lexington, KY 40356.
TO THE EDITOR:
We are concerned about the recent series of guideline papers and recommendation statements published in Annals (1–3), which seem to advise primary care physicians not to perform spirometry. This could be a big blow (no pun intended) to a nationwide effort to diagnose and treat chronic obstructive pulmonary disease (COPD) early (4, 5). Chronic obstructive pulmonary disease is the only disease among the top 5 fatal diseases in the United States that is increasing in morbidity and mortality (6). What separates the diseases that are decreasing (heart disease, stroke, cancer, and accidents) from COPD are effective early detection and prevention strategies. The recommendation in the U.S. Preventive Services Task Force (USPSTF) clinical summary figure, in large bold letters, states: “Do not screen for chronic obstructive pulmonary disease using spirometry” (2). In the text below the figure, however, there are caveats: this recommendation applies to healthy adults who do not recognize or report symptoms to a clinician and does not apply to …
