Table 1

Types of overdiagnosis and misdiagnosis

1Physician COPD diagnosis despite normal spirometry
The physician did not use spirometry to establish a diagnosis of COPD (and a normal spirometry was later found in the study)
The physician “ignored” a normal spirometry result
2Discordant results for COPD diagnosis based on different spirometry-based definitions for airflow obstruction (e.g. post-bronchodilator FEV1/FVC <0.7 or FEV1/FVC <LLN)
3COPD diagnosis based on pre-bronchodilator spirometry results
4Comorbidities (e.g. heart failure or asthma) that affect spirometry and have clinical features which overlap with COPD
5Normalisation of abnormal (post-bronchodilator) spirometry at follow-up