Asthma-chronic obstructive pulmonary disease misdiagnosis: cause for concern or false alarm?

Chronic obstructive pulmonary disease (COPD) and asthma are both heterogeneous disorders characterized by overlapping respiratory symptoms. Due to overlapping symptoms and underuse of spirometry, there is often misdiagnosis between these two disorders. A cross-sectional observational study was carried out at the respiratory outpatient department (OPD) of a tertiary care respiratory center in western Maharashtra for 1 year. All patients over the age of 40 who were diagnosed with asthma or COPD and were referred to the respiratory OPD for management or were already under follow-up at the center were included in the study. Questionnaires and spirometry were used to evaluate all patients. A total of 85 patients who met the inclusion criterion without any exclusion requirements were included; 5 patients out of 45 who were initially labelled as having asthma (11.11%) and 29 patients out of 40 who were initially labelled as having COPD (72.5%) were found to have been misdiagnosed according to study protocol. In conclusion, there is a significant prevalence of misdiagnosis amongst obstructive airway disease. The patients with a diagnostic label of COPD are more likely to be misdiagnosed due to a lack of knowledge of diagnostic protocol, underuse and misinterpretation of spirometry, and overreliance on chest radiography. Use of spirometry is dismally low and correlates with other studies from India. The study clearly indicates the urgent requirement of educating doctors, especially primary care clinicians, about the correct diagnostic protocols used in the diagnosis of COPD and bronchial asthma.