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Diagnosis
Smoking, age, and laryngeal height predicted obstructive airway disease in adults

https://doi.org/10.1136/ebm.6.1.23

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    (2000) JAMA 283, 1853. Straus SE, McAlister FA, Sackett DL. , et al, for the CARE-COAD1 Group.. The accuracy of patient history, wheezing, and laryngeal measurements in diagnosing obstructive airway disease.. Apr 12;. :. –7.
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 QUESTION: How accurate are the clinical examination and patient history in the diagnosis of obstructive airway disease (OAD)?

    Design

    Blinded comparison of items from the clinical examination and patient history (self reported OAD, smoking history, wheezing on auscultation, maximum and minimum laryngeal height, and laryngeal descent) with spirometric results (FEV1 and FEV1–FVC ratio 5th centile).

    Setting

    20 investigator groups in primary, secondary, and tertiary care centres in 14 countries.

    Patients

    332 patients were recruited, and 309 (mean age 56 y, 57% men, 89% white) were included in the analysis. Patients were recruited so that approximately one third had confirmed OAD, one third had suspected OAD, and one third had no evidence of OAD. Exclusion criteria were reversible airway obstruction, terminal illness, age <18 years, severe respiratory distress, or inability …

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    Footnotes

    • Sources of funding: UK National Health Service Research and Development Programme and Medical Research Council of Canada.

    • For correspondence: Dr F A McAlister, Division of General Internal Medicine, 2E3.24 Walter Mackenzie Centre, University of Alberta Hospital, 8440 112 Street, Edmonton, Alberta T6G 2R7, Canada. Fax +1 780 407 2680.