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COPD Diagnostic Criteria

DIAGNOSIS 

Patients with an FEV1/FVC post brochodilation <70 percent can be diagnosed with COPD and should be offered an annual review.

FEV1 required at least once to confirm diagnosis.

Click here to view an example of how to interpret the report for FEV1FVC.

Click here to view an example of how to interpret the report for FEV1.

PLEASE NOTE: SCI-Gateway should be used for Spirometry referrals.

Use Gateway, and use Respiratory Direct Services on drop-down list, then choose Spirometry.

Respiratory SCI.PNG

• Patients with FEV1 >80% predicted post bronchodilator should only be diagnosed with COPD if they have consistent symptoms.

Classification – as amended by NICE, 2010

• Mild: FEV1 >80% predicted (if symptomatic).
• Moderate: FEV1 50-79% predicted.
• Severe: FEV1 30-49% predicted.
• Very severe: FEV1 <30% predicted.

Click here for full NHSGG&C guideline on the use of Spirometry in Primary Care.

 ASTHMA

Diagnoses of asthma and COPD can co-exist. Consider asthma diagnosis (if not already recorded) if FEV1 response to salbutamol >0.4 litres.

Use 33H1 if >0.4 litres.

If response between 200 and 400 mls (do not use code 33H1), a trial of steroids may be recommended - consult GP.

Patients who meet the diagnostic criteria for both asthma and COPD should be included on both registers.

 CHEST X-RAY

CXR required at least once if date of diagnosis after April 2009.

If no chest x-ray, please consult GP - click here for COPD guidelines.