Evidence-based On-call

Exacerbation of Chronic Obstructive Pulmonary Disease

Clinical features

Ask about a previous history of COPD ^a

Why?

A self-reported history of chronic obstructive airways disease makes COPD more likely

Patient	Target Disorder and Reference Standard	Diagnostic Test	LR+ (95% CI)	Post-test Probability	LR- (95% CI)	Post-test Probability
patient visiting doctor ^a (pre-test probability: 52%)	COPD (spirometry)	smoking history > 40 pack-years	7.3	89%	0.5	35%