Characteristics and risk factors of patients with undiagnosed COPD in China: results of a nationwide study from the ‘Happy Breathing’ Programme with mixed methods evaluation

作者：Xingyao Tang, Jun Pan, Fang Fang, Yong Li, Jieping Lei, Hongtao Niu, Wei Li, Fen Dong, Zhoude Zheng, Yaodie Peng, Ting Yang, Chen Wang, Cunbo Jia, Ke Huang · 发表于：BMJ Health & Care Informatics · 年份：2025 · DOI：10.1136/bmjhci-2024-101323 · 被引用次数：1 · 研究领域：Chronic Obstructive Pulmonary Disease (COPD) Research、Respiratory and Cough-Related Research、Delphi Technique in Research

OBJECTIVES: Due to the big disease burden of undiagnosed chronic obstructive pulmonary disease (COPD), we aimed to investigate the differences in the characteristics and risk factors of patients with undiagnosed COPD in China. METHODS: We used data from the 'Happy Breathing' Programme through April 2023. Current study is a cohort design. Participants were divided into high risk, undiagnosed and diagnosed COPD. Univariate logistic regression, lasso regression, decision tree, random forest and gradient boosting machine were used to screen the variables. Comparisons were conducted between undiagnosed and patients with diagnosed COPD. RESULTS: A total of 1603 high-risk, 4688 undiagnosed and 1634 patients with diagnosed COPD were identified. Patients with undiagnosed COPD had the lowest level of education, the poorest COPD-related knowledge and most biofuel users compared with high-risk populations and diagnosed patients (p<0.001). After multivariable logistic regression analysis, COPD-related knowledge score (OR=0.96, 95% CI 0.95 to 0.97), COPD Assessment Test Score (OR=1.01, 95% CI 1.00 to 1.02) and modified Medical Research Council Dyspnea Scale (OR=1.26, 95% CI 1.14 to 1.39) remained significant. Analysis of follow-up data showed that patients with undiagnosed COPD had lighter symptoms and experienced less acute exacerbations than diagnosed patients (p<0.001). DISCUSSION: Most patients with COPD remain undiagnosed until they feel dyspnoea or hospitalisation due to acute exacer...