There’s room to change the game in early COPD detection—here's how
Key Takeaways
A significant portion of COPD patients go undiagnosed due to subtle early symptoms and limited use of spirometry.
COPD is no longer just a smoker's disease, with risk factors like air pollution, biomass exposure, and workplace dust making targeted case-finding more effective than broad screening.
Emerging technologies like handheld spirometry devices and AI-driven diagnostics hold promise for improving early detection in resource-limited settings.
Early diagnosis of chronic obstructive pulmonary disease (COPD) is vital for effective management and improved patient outcomes. MDLinx spoke with the experts to discuss effective strategies for early diagnosis, and the innovative tools and technologies improving early detection.
Comparing strategies
Currently, the two primary strategies for early COPD diagnosis are screening and case-finding. Alok Mohta, MD, MBBS, a board-certified physician working in Jodhpur, India, with over 30 years of experience treating COPD, provides some clarity.
"Screening and case-finding are often mistakenly seen as the same, but it's important to distinguish between them."
— Alok Mohta, MD, MBBS
"Screening targets the general population to detect COPD while case-finding focuses on individuals with respiratory symptoms and risk factors,” Dr. Mohta says.
Dr. Mohta advocates for targeted case-finding: “Case-finding is definitely more effective. Screening the whole population is unrealistic and unnecessary. Focusing on high-risk individuals—smokers, those with chronic respiratory issues, or people exposed to pollutants—gives us better results," he says.
According to the 2023 GOLD guidelines and updated USPSTF recommendations, case-finding is favored for early COPD detection, as routine population screening has not shown to be cost-effective or beneficial.[][][]
Revolutionary tools
Recent studies also support the effectiveness of case-finding using questionnaires combined with handheld spirometers.[] Tools such as the COPD-6 and Piko-6 devices, or even smartphone-based spirometry, offer a practical alternative for early detection in resource-limited settings.
Combining these tools with questionnaires has been shown to reduce the need for full spirometry by up to 90%, making detection both cost-effective and efficient.
Integrating AI and into diagnostics is also a relevant approach. “New technologies like AI and machine learning are being developed to analyze lung health data and identify early signs of COPD,” Dr. Raj says. A 2024 study found that neural networks using post-bronchodilator spirometric data models can accurately diagnose COPD with 92.9% accuracy, 88.2% sensitivity, and 94.3% specificity—outperforming the current gold standard, spirometry—and shows promise in primary care settings.[]
Streamlining care with PCPs
“Recently, there’s been a greater focus on recognizing the importance of early diagnosis in the medical community, which could hopefully lead to better health outcomes,” Dr. Raj syas. One such initiative is raising awareness among primary care physicians about subtle symptoms. By increasing vigilance for COPD signs, even in mild cases, early detection rates can improve significantly.
“Education is everything,” says Dr. Mohta. “If primary care doctors ask the right questions, like about breathlessness during regular activities or persistent cough, they’ll catch COPD earlier."
"Additionally, recognizing environmental risk factors is crucial," he adds. "COPD is not just a smoker’s disease, and expanding risk assessment beyond smoking history will uncover more cases."
"Early detection changes the course of COPD."
— Alok Mohta, MD, MBBS
"With timely intervention—whether it’s quitting smoking, starting medication, or beginning pulmonary rehab—we can prevent the worst outcomes,” Dr. Mohta says.
What this means for you
Early intervention is crucial for altering the course of COPD and preventing severe complications. The two primary strategies for early COPD diagnosis are screening and case-finding—many physicians believe case-finding to be the more effective approach, as it targets high-risk individuals rather than the general population. In addition, innovative tools like handheld spirometers and AI technologies enhance early detection, achieving high accuracy.
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