Abstract：
Rationale: A significant proportion of individuals with chronic obstructive pulmonary disease (COPD) and asthma remain undiagnosed. Objectives: The objective of this study was to evaluate symptoms, quality of life, healthcare use, and work productivity in subjects with undiagnosed COPD or asthma compared with those previously diagnosed, as well as healthy control subjects. Methods: This multicenter population-based case-finding study randomly recruited adults with respiratory symptoms who had no previous history of diagnosed lung disease from 17 Canadian centers using random digit dialing. Participants who exceeded symptom thresholds on the Asthma Screening Questionnaire or the COPD Diagnostic Questionnaire underwent pre- and post-bronchodilator spirometry to determine if they met diagnostic criteria for COPD or asthma. Two control groups, a healthy group without respiratory symptoms and a symptomatic group with previously diagnosed COPD or asthma, were similarly recruited. Measurements and Main Results: A total of 26,905 symptomatic individuals were interviewed, and 4,272 subjects were eligible. Of these, 2,857 completed pre- and post-bronchodilator spirometry, and 595 (21%) met diagnostic criteria for COPD or asthma. Individuals with undiagnosed COPD or asthma reported greater impact of symptoms on health status and daily activities, worse disease-specific and general quality of life, greater healthcare use, and poorer work productivity than healthy control subjects. Individuals with undiagnosed asthma had symptoms, quality of life, and healthcare use burden similar to those of individuals with previously diagnosed asthma, whereas subjects with undiagnosed COPD were less disabled than those with previously diagnosed COPD. Conclusions: Undiagnosed COPD or asthma imposes important, unmeasured burdens on the healthcare system and is associated with poor health status and negative effects on work productivity.
摘要：
背景：相当比例的COPD和哮喘患者仍未确诊。
目的：本研究的目的是评估症状，生活质量,与先前诊断的COPD或哮喘患者相比，未诊断的COPD或哮喘患者的医疗保健利用率和工作效率，以及健康的控制。
方法：这项基于多中心人群的病例发现研究使用随机数字拨号方法，从加拿大17个中心随机招募了有呼吸道症状、以前没有肺部疾病诊断史的成年人。超过哮喘筛查问卷或COPD诊断问卷症状阈值的参与者接受支气管扩张药前和后肺活量测定，以确定他们是否符合COPD或哮喘的诊断标准。两个对照组,没有呼吸道症状的健康组和先前诊断为COPD或哮喘的有症状组，同样被招募。
结果：对26,905名有症状的个体进行了访谈，4,272名受试者符合资格。其中,2,857人完成支气管扩张剂前后肺活量测定，595人(21%)符合COPD或哮喘的诊断标准。未确诊的COPD或哮喘患者报告症状对健康状况和日常活动的影响更大。疾病特异性和一般生活质量较差，与健康对照相比，医疗保健利用率更高，工作效率更差。未确诊的哮喘患者也有类似的症状，生活质量,与以前诊断为哮喘的人相比，医疗保健利用负担，与先前诊断为COPD的受试者相比，未诊断为COPD的受试者的残疾较少。
结论：未确诊的COPD或哮喘具有重要作用，医疗保健系统无法衡量的负担，并与不良的健康状况和对工作效率的负面影响有关。
目的：本研究的目的是评估症状，生活质量,与先前诊断的COPD或哮喘患者相比，未诊断的COPD或哮喘患者的医疗保健利用率和工作效率，以及健康的控制。
方法：这项基于多中心人群的病例发现研究使用随机数字拨号方法，从加拿大17个中心随机招募了有呼吸道症状、以前没有肺部疾病诊断史的成年人。超过哮喘筛查问卷或COPD诊断问卷症状阈值的参与者接受支气管扩张药前和后肺活量测定，以确定他们是否符合COPD或哮喘的诊断标准。两个对照组,没有呼吸道症状的健康组和先前诊断为COPD或哮喘的有症状组，同样被招募。
结果：对26,905名有症状的个体进行了访谈，4,272名受试者符合资格。其中,2,857人完成支气管扩张剂前后肺活量测定，595人(21%)符合COPD或哮喘的诊断标准。未确诊的COPD或哮喘患者报告症状对健康状况和日常活动的影响更大。疾病特异性和一般生活质量较差，与健康对照相比，医疗保健利用率更高，工作效率更差。未确诊的哮喘患者也有类似的症状，生活质量,与以前诊断为哮喘的人相比，医疗保健利用负担，与先前诊断为COPD的受试者相比，未诊断为COPD的受试者的残疾较少。
结论：未确诊的COPD或哮喘具有重要作用，医疗保健系统无法衡量的负担，并与不良的健康状况和对工作效率的负面影响有关。
