Testing & Diagnosis

According to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) Management Guidelines (2001), the definition of COPD is that:

StehoscopeChronic Obstructive Pulmonary Disease (COPD) is a preventable and treatable disease with some significant extrapulmonary effects that may contribute to the severity in individual patients. Its pulmonary component is characterized by airflow limitation that is not fully reversible. The airflow limitation is usually progressive and associated with an abnormal inflammatory response of the lung to noxious particles or gases.

In 2004, the American Thoracic Society (ATS) and European Respiratory Society (ERS) developed a document in effort to standardize diagnosis and treatment of COPD in individuals. The definition of COPD in this document is similar to that developed in the GOLD guidelines:

Chronic Obstructive Pulmonary Disease (COPD) is a preventable and treatable disease state characterized by airflow limitation that is not fully reversible. The airflow limitation is usually progressive and is associated with an abnormal inflammatory response of the lungs to noxious particles or gases, primarily caused by cigarette smoking. Although COPD affects the lungs, it also produces significant systemic consequences.”

Both definitions demonstrate the possibility of preventing and treating the disease with the help of early diagnosis. Diagnosis for COPD can be achieved through simple breathing tests, such as spirometry, alongside other testing.

Spirometry
The quickest and easiest method to diagnose COPD is with spirometry. According to the ATS/ERS guidelines, spirometry should be obtained from all individuals who have symptoms, have/had a history of smoking and/or environmental exposure to smoke or occupational pollutants, and have a family history of chronic lung disease. (For more information about spirometry testing and classification, visit the next section or click here.)

Bronchodilator Reversibility
The ATS/ERS guidelines recommend using bronchodilator reversibility at least once on a patient in order to “exclude asthma and to establish the best lung function for the individual patient, and, to a lesser degree, to estimate the prognosis” (2004).

Chest Radiography
Though it is not essential for diagnosis, chest radiography does help eliminate the possibility of other diseases such as pneumonia, cancer, and congestive heart failure (ATS/ERS 2004).

Alpha-1 Antitrypsin Deficiency Testing
The World Health Organization (WHO), ATS, ERS, and the Alpha-1 Foundation’s Medical and Scientific Advisory Committee (MASAC) recommended that individuals diagnosed with COPD should be tested for Alpha-1 Antitrypsin Deficiency (AAT). Because AAT is the most common known genetic risk factor for COPD at this time, it is important to test all individuals with COPD for this protein deficiency. Detection of this disease could lead to a different therapy for an individual with COPD. For more information about AAT testing, visit the Alpha-1 Foundation’s website.

Computed Tomography
If diagnosis for COPD is unclear, CT scanning is recommended.