Asthma and COPD are clearly differentiated… on paper. But in real life, diagnosing one or the other isn’t as straightforward as the books say. It is very common for patients to present symptoms that are very common in both diseases.
The study “Diagnostic differentiation between asthma and COPD in primary care using lung function testing” focused on finding a more functional way to diagnose patients correctly. This clinical trial demonstrated the value of performing lung function tests from first contact.
By América Torres
Asthma vs. COPD
The authors of the clinical trial conducted a cross-sectional study in 10 general practitioner offices in the Netherlands. They compared patients diagnosed with asthma, patients diagnosed with COPD and subjects without data of pulmonary obstruction of airways. Individuals with pre-existence of asthma, COPD or other airway diseases were excluded.
- A total of 532 subjects participated, whose respiratory symptoms and lung function were thoroughly examined.
- They were instructed to discontinue the use of bronchodilators for a specific period of hours before undergoing pulmonary function tests.
- Pulmonary function tests included pre- and post-bronchodilator spirometry, DLCO measurements, and bronchial hyperresponsiveness.
- Two chest physicians assessed if patients had asthma or COPD.
- To differentiate asthma from COPD, multivariate logistic regression was analyzed considering three scenarios: only the patient’s history, the available diagnosis of the first contact physician, and the diagnoses available for secondary care.
- For each scenario, the curve (ROC) of the operating characteristic of the receiver and the area below the curve (AUC) was calculated considering the evaluation of chest physicians as a gold standard.
- All tests were performed by certified technicians at a hospital-based lung function laboratory.
- Researchers used standards of the American Thoracic Society of 1994.
- They also calculated the predicted normal lung function values for FEV1 based on the values of the European Community for Coal and Steel (ECCS)
Results
Of the total participants, 84 subjects were diagnosed with asthma, 138 with COPD and 310 showed no chronic respiratory disease. In the scenario that included only patient history data, the ROC characteristics of the model showed an AUC of 0.84 (95% CI 0.78–0.89) to differentiate between asthma and COPD.
By including available primary care diagnoses (that is to say, pre- and post-bronchodilator spirometry), the AUC increased to 0.89 (95% CI 0.84–0.93, P = 0.020). When the most advanced diagnostic tests obtained in secondary care were added, the AUC remained at 0.89 (95% CI 0.85–0.94, P = 0.967).
Conclusion: The critical role of spirometry in family medicine
The authors of this clinical trial concluded that primary care physicians can effectively differentiate between asthma and COPD when they combine a thorough review of the patient’s medical history with post-bronchodilator spirometry. For this reason, they recommend that spirometry training should be a mandatory part of general practice, enabling family doctors to make more accurate and timely diagnoses.
Spirometry made easy for primary care
To accurately determine whether a patient should be referred to a pulmonologist, family doctors need more than just training—they need a spirometer that delivers reliable, accurate results with minimal effort. A device that is easy to use and provides high-quality data can streamline clinical decisions and ensure patients receive the care they need, when they need it most.
This is where spirometry proves its value—not only as a diagnostic tool, but as a key component in distinguishing between asthma and COPD early and effectively. And when enhanced with the precision of SharpFlow (ultrasonic) technology, as in the case of our SpiroScout spirometer, the benefits become even more evident.
SpiroScout provides reliable tests because it measures even very low flows, and this can make the work of primary care physicians easier, since it is not necessary for them to repeat the maneuver. And it can also improve the quality of life of the patient, who can obtain accurate and early diagnoses.
This short video demonstrates just how easy it is for family doctors to perform accurate, reliable spirometry tests using SpiroScout. This device combines cutting-edge technology with user-friendly features that simplify workflow and support confident clinical decisions.
Why SpiroScout is the Smart Choice for Primary Care:
- Calibration-free. Always ready, no daily calibration needed. Just insert the ScoutTube mouthpiece and start testing.
- Maintenance-free & easy to clean. No screens, keyboards, or buttons
- Fully compliant with ATS/ERS guidelines.
- Custom reports in a few clicks. They can also include physician info
- ScoutTube mouthpieces. Affordable, hygienic, designed to prevent cross-contamination, and environmentally safe.
- Portable. Use it in your clinic or take it with you on the go
- Ultrasonic precision. Delivers highly accurate results with no moving parts
- Real-Time BTPS correction. For consistent, reliable measurements
- Seamless integration. Connects easily with your EMR and HIS
- Cybersecure. Patient data stays protected.
- Peace of mind. Backed by a 3-year warranty and SCHILLER’s world-class client service, which ensures ongoing technical support and a continuous supply of consumables. Preventive maintenance and repairs are carried out using original parts by certified engineers, with fast turnaround times to minimize device downtime..
- LFX Software. Offers a unique trending feature for effective patient follow-up.
Book a free one-on-one session with a SCHILLER specialist and discover how SpiroScout can help you deliver accurate, reliable, and early diagnoses with confidence. No purchase commitment—just expert guidance tailored to your practice.
REFERENCE
Bouwens, J.D.M., Bischoff, E.W.M.A., in ’t Veen, J.C.C.M. et al. Diagnostic differentiation between asthma and COPD in primary care using lung function testing. npj Prim. Care Respir. Med. 32, 32 (2022). https://doi.org/10.1038/s41533-022-00298-4