The subject matter was very clear and the related warning dire at the annual meeting of the American College of Chest Physicians (CHEST) in Honolulu recently: Dual standards for evaluating chronic obstructive pulmonary disease (COPD) are leading to misdiagnosis and improper treatment for many patients.
Results from a detailed study on COPD classifications were delivered at the meeting, with presenter Ameer Rasheed, MD, from the Brooklyn Hospital Center, noting that the two competing standards commonly used to diagnose COPD often result in very different conclusions.
In short form, those standards are called GOLD and ATS/ERS, respectively. Although study researchers point to numerous complex discrepancies between the two systems that can lead to different results and medical errors in diagnosis, one point is especially stark and clear: The GOLD standard diagnoses COPD in older patients far more frequently than does ATS/ERS, while use of the latter classification leads to more COPD diagnoses in younger patients.
That disparity and others need to be remedied, say researchers.
"There is a need for a joint GOLD-ATR/SERS consensus statement to resolve these conflicts," Rasheed told colleagues in Hawaii.
Aside from the potential for different medical outcomes resulting from the two standards, cost, too, is implicated. Rasheed used a specific example to point this out.
He noted that treatment costs can vary widely based on whether a diagnosis calls for using long-acting beat agonists or a shorter acting variety.
Another presenter stated that disparity in diagnosis and subsequent treatment choices are especially important for patients with mild to moderate symptoms.
Source: Medscape, "Conflicting standards for COPD could hurt patients" Oct. 24, 2011
