Causes of misdiagnosis of chronic obstructive pulmonary disease: A systematic scoping review

Background: Chronic obstructive pulmonary disease (COPD) has serious implications at both the individual and the societal level. It is crucial that COPD is diagnosed correctly to ensure provision of the right treatment. However, the current diagnostic procedures may lead to misdiagnosis. Aim: The aim of this scoping review was to disseminate knowledge about potential causes of misdiagnosis of COPD. Methods: A systematic, comprehensive search was performed in PubMed, Embase and Cinahl. Results: A thorough review produced a sample of 73 articles. The synthesis revealed five potential causes of misdiagnosis of COPD, including: the threshold for defining COPD (n = 36), errors made in primary care (n = 15), errors linked to the spirometry test (n = 13), differential diagnoses (n = 10), and patient related factors (n = 8). Conclusions: The causes of misdiagnosis of COPD are attributable mainly to spirometry and to the healthcare professional performing the diagnostic assessment. With a view to limiting misdiagnosis of COPD, future research should help clarify strategies for alternative objective tests for determining if a patient has COPD and explore how to better support primary care in the diagnosing of COPD. (C) 2017 Elsevier Ltd. All rights reserved.