{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T23:13:07Z","timestamp":1787008387349,"version":"build-2736575974"},"reference-count":29,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2026,2,21]],"date-time":"2026-02-21T00:00:00Z","timestamp":1771632000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100000050","name":"National Heart Lung and Blood Institute","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004325","name":"AstraZeneca","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004325","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004330","name":"GlaxoSmithKline","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004330","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,6,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Assess the impact in primary care of the 2025 Global Obstructive Lung Disease comment to use prebronchodilator results when they do not demonstrate obstruction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>Data from participants of the chronic obstructive pulmonary disease (COPD) Assessment in Primary Care To Identify Undiagnosed Respiratory Disease and Exacerbation study who had baseline pre- and postbronchodilator (BD) spirometry were used to assess the pre-BD results ability to predict post-BD obstruction, defined as forced expiratory volume in 1 second (FEV1)\/forced vital capacity (FVC)\u2009&amp;lt;0.70. Spirometry data were stratified into 4 groups: (1) consistent nonobstruction, (2) only post-BD obstruction\u2014missed diagnosis, (3) consistent obstruction, and (4) only pre-BD obstruction\u2014over diagnosed. Sensitivity, specificity, and positive and negative predictive values of the pre-BD results to predict post-BD obstruction were calculated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 1181 of 4336 participants (27.2%) were included in this study because they met the study\u2019s criteria for pre- and post-BD spirometry: pre-BD obstruction (FEV1\/FVC\u2009&amp;lt;0.70) or FEV1\u2009&amp;lt;\u200980% predicted. Of the 1181, 701 (59.4%) had consistent nonobstruction with 26 (2.2%) having only post-BD obstruction\u2014missed diagnosis of COPD by pre-BD, whereas 273 (23.1%) had consistent obstruction. 181 (15.3% of the 1181 or 4.2% of the 4336) had only pre-BD obstruction\u2014overdiagnosis of COPD. Pre-BD sensitivity for post-BD obstruction (labeled COPD) was 91.3% (95% CI, 87.5\u201394.2) with specificity 79.5% (95% CI, 76.7\u201382.1), negative predictive value 96.4% (95% CI, 94.8\u201397.7), and positive predictive value 60.1% (95% CI, 55.5\u201364.7).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Using the 2025 Global Obstructive Lung Disease recommendations in these primary care patients with pre-BD spirometry showing obstruction or an FEV1\u2009&amp;lt;\u200980% predicted resulted in few missed diagnoses of COPD or obstruction. Our data confirm that nonobstructive pre-BD results may be used routinely in primary care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/annalsats\/aaoag020","type":"journal-article","created":{"date-parts":[[2026,2,21]],"date-time":"2026-02-21T14:21:49Z","timestamp":1771683709000},"page":"873-883","source":"Crossref","is-referenced-by-count":1,"title":["A CAPTURE ancillary study to assess GOLD 2025 spirometry recommendations in primary care adults"],"prefix":"10.1093","volume":"23","author":[{"given":"Barbara P","family":"Yawn","sequence":"first","affiliation":[{"name":"Department of Family and Community Health, University of Minnesota , Minneapolis, MN,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela","family":"Angulo","sequence":"additional","affiliation":[{"name":"School of Public Health, University of Michigan , Ann Arbor, MI,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min","family":"Joo","sequence":"additional","affiliation":[{"name":"Division of Pulmonary, Critical Care, Sleep, and Allergy, University of Illinois Chicago , Chicago, IL,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Mannino","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine, University of Kentucky , Lexington, KY,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Murray","sequence":"additional","affiliation":[{"name":"School of Public Health, University of Michigan , Ann Arbor, MI,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"Meldrum","sequence":"additional","affiliation":[{"name":"Division of Pulmonary & Critical Care Medicine, University of Michigan , Ann Arbor, MI,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barry","family":"Make","sequence":"additional","affiliation":[{"name":"Division of Pulmonary, Critical Care, and Sleep Medicine, National Jewish Health , Denver, CO,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"MeiLan K","family":"Han","sequence":"additional","affiliation":[{"name":"Division of Pulmonary & Critical Care Medicine, University of Michigan , Ann Arbor, MI,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernando","family":"Martinez","sequence":"additional","affiliation":[{"name":"Divison of Pulmonary and Critical Care Medicine, University of Massachusetts , Springfield, MA,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,2,21]]},"reference":[{"key":"2026071404060147500_aaoag020-B1","doi-asserted-by":"publisher","first-page":"591","DOI":"10.4187\/respcare.06276","article-title":"COPD care in the 21st century: a public health priority","volume":"63","author":"Criner","year":"2018","journal-title":"Respir Care"},{"key":"2026071404060147500_aaoag020-B2","author":"GOLD Science Committee","year":"2025"},{"key":"2026071404060147500_aaoag020-B3","doi-asserted-by":"publisher","first-page":"e000213","DOI":"10.1136\/bmjresp-2017-000213","article-title":"Predictive value of prebronchodilator and postbronchodilator spirometry for COPD features and outcomes","volume":"4","author":"Fortis","year":"2017","journal-title":"BMJ Open Respir Res"},{"key":"2026071404060147500_aaoag020-B4","doi-asserted-by":"publisher","first-page":"136","DOI":"10.1186\/1465-9921-12-136","article-title":"Pre- and post-bronchodilator lung function as predictors of mortality in the lung health study","volume":"12","author":"Mannino","year":"2011","journal-title":"Respir Res"},{"key":"2026071404060147500_aaoag020-B5","doi-asserted-by":"publisher","first-page":"e1183","DOI":"10.1016\/S2214-109X(23)00217-6","article-title":"The global economic burden of chronic obstructive pulmonary disease for 204 countries and territories in 2020\u201350: a health-augmented macroeconomic modelling study","volume":"11","author":"Chen","year":"2023","journal-title":"Lancet Glob Health"},{"key":"2026071404060147500_aaoag020-B6","doi-asserted-by":"publisher","first-page":"1277","DOI":"10.2147\/COPD.S406208","article-title":"Trajectories of spirometric patterns, obstructive and PRISm, in a population-based cohort in Latin America","volume":"18","author":"Perez-Padilla","year":"2023","journal-title":"Int J Chron Obstruct Pulmon Dis"},{"key":"2026071404060147500_aaoag020-B7","doi-asserted-by":"publisher","first-page":"1397","DOI":"10.1164\/rccm.201804-0663OC","article-title":"Longitudinal phenotypes and mortality in preserved ratio impaired spirometry in the COPDGene study","volume":"198","author":"Wan","year":"2018","journal-title":"Am J Respir Crit Care Med"},{"key":"2026071404060147500_aaoag020-B8","doi-asserted-by":"publisher","first-page":"210","DOI":"10.1164\/rccm.201911-2115OC","article-title":"Lung function trajectories leading to chronic obstructive pulmonary disease as predictors of exacerbations and mortality","volume":"202","author":"Marott","year":"2020","journal-title":"Am J Respir Crit Care Med"},{"key":"2026071404060147500_aaoag020-B9","doi-asserted-by":"publisher","first-page":"221","DOI":"10.2147\/POR.S478721","article-title":"Preserved ratio impaired spirometry in US primary care patients diagnosed with chronic obstructive pulmonary disease","volume":"15","author":"Evans","year":"2024","journal-title":"Pragmat Obs Res"},{"key":"2026071404060147500_aaoag020-B10","doi-asserted-by":"publisher","first-page":"490","DOI":"10.1001\/jama.2023.0128","article-title":"Discriminative accuracy of the CAPTURE tool for identifying chronic obstructive pulmonary disease in US primary care settings","volume":"329","author":"Martinez","year":"2023","journal-title":"JAMA"},{"key":"2026071404060147500_aaoag020-B11","doi-asserted-by":"publisher","first-page":"789","DOI":"10.1164\/rccm.202405-0921OC","volume-title":"Am J Respir Crit Care Med","author":"Martinez","year":"2025"},{"key":"2026071404060147500_aaoag020-B12","doi-asserted-by":"publisher","first-page":"60","DOI":"10.15326\/jcopdf.2020.0155","article-title":"Protocol summary of the COPD assessment in primary care to identify undiagnosed respiratory disease and exacerbation risk (CAPTURE) validation in primary care study","volume":"8","author":"Yawn","year":"2021","journal-title":"Chronic Obstr Pulm Dis"},{"key":"2026071404060147500_aaoag020-B13","doi-asserted-by":"publisher","first-page":"648","DOI":"10.1183\/09031936.00102509","article-title":"Development and first validation of the COPD assessment test","volume":"34","author":"Jones","year":"2009","journal-title":"Eur Respir J"},{"key":"2026071404060147500_aaoag020-B14","doi-asserted-by":"crossref","first-page":"1665","DOI":"10.1136\/bmj.2.5213.1665","article-title":"Standardized questionnaires on respiratory symptoms","volume":"2","author":"Fletcher","year":"1960","journal-title":"British Med J"},{"key":"2026071404060147500_aaoag020-B15","doi-asserted-by":"publisher","first-page":"32","DOI":"10.3109\/15412550903499522","article-title":"Genetic epidemiology of COPD (COPDGene) study design","volume":"7","author":"Regan","year":"2010","journal-title":"COPD"},{"key":"2026071404060147500_aaoag020-B16","volume-title":"PATH Study Data Tables and Figures"},{"key":"2026071404060147500_aaoag020-B17","doi-asserted-by":"publisher","first-page":"319","DOI":"10.1183\/09031936.05.00034805","article-title":"Standardisation of spirometry","volume":"26","author":"Miller","year":"2005","journal-title":"Eur Respir J"},{"key":"2026071404060147500_aaoag020-B18","doi-asserted-by":"publisher","first-page":"89","DOI":"10.1186\/s12931-014-0089-y","article-title":"Epidemiology, genetics, and subtyping of preserved ratio impaired spirometry (PRISm) in COPDGene","volume":"15","author":"Wan","year":"2014","journal-title":"Respir Res"},{"key":"2026071404060147500_aaoag020-B19","doi-asserted-by":"publisher","first-page":"323","DOI":"10.3109\/15412555.2010.510161","article-title":"Significant bronchodilator responsiveness and \u201creversibility\u201d in a population sample","volume":"7","author":"Prentice","year":"2010","journal-title":"COPD: Journal of Chronic Obstructive Pulmonary Disease"},{"key":"2026071404060147500_aaoag020-B20","doi-asserted-by":"publisher","first-page":"2287","DOI":"10.1001\/jama.2021.20939","article-title":"Association between preserved ratio impaired spirometry and clinical outcomes in US adults","volume":"326","author":"Wan","year":"2021","journal-title":"JAMA"},{"key":"2026071404060147500_aaoag020-B21","doi-asserted-by":"publisher","first-page":"407","DOI":"10.2147\/COPD.S76047","article-title":"Detection of COPD in a high-risk population: should the diagnostic work-up include bronchodilator reversibility testing?","volume":"10","author":"Kjeldgaard","year":"2015","journal-title":"Int J Chron Obstruct Pulmon Dis"},{"key":"2026071404060147500_aaoag020-B22","doi-asserted-by":"publisher","first-page":"319","DOI":"10.1370\/afm.2829","article-title":"COPD population in US primary care: data from the optimum patient care DARTNet research database and the advancing the patient experience in COPD registry","volume":"20","author":"Pace","year":"2022","journal-title":"Ann Fam Med"},{"key":"2026071404060147500_aaoag020-B23","doi-asserted-by":"publisher","first-page":"651","DOI":"10.1016\/j.chest.2021.09.021","article-title":"Significant spirometric transitions and preserved ratio impaired spirometry among ever smokers","volume":"161","author":"Wan","year":"2022","journal-title":"Chest"},{"key":"2026071404060147500_aaoag020-B24","doi-asserted-by":"publisher","first-page":"149","DOI":"10.1016\/S2213-2600(21)00369-6","article-title":"Prevalence, risk factors, and clinical implications of preserved ratio impaired spirometry: a UK biobank cohort analysis","volume":"10","author":"Higbee","year":"2022","journal-title":"Lancet Respir Med"},{"key":"2026071404060147500_aaoag020-B25","doi-asserted-by":"publisher","first-page":"208","DOI":"10.1186\/s12931-024-02841-y","article-title":"The prevalence and mortality risks of PRISm and COPD in the United States from NHANES 2007-2012","volume":"25","author":"Cadham","year":"2024","journal-title":"Respir Res"},{"key":"2026071404060147500_aaoag020-B26","doi-asserted-by":"publisher","first-page":"1901217","DOI":"10.1183\/13993003.01217-2019","article-title":"Trajectory and mortality of preserved ratio impaired spirometry: the rotterdam study","volume":"55","author":"Wijnant","year":"2020","journal-title":"Eur Respir J"},{"key":"2026071404060147500_aaoag020-B27","doi-asserted-by":"publisher","first-page":"414","DOI":"10.1164\/rccm.202008-3328PP","article-title":"From GOLD 0 to pre-COPD","volume":"203","author":"Han","year":"2021","journal-title":"Am J Respir Crit Care Med"},{"key":"2026071404060147500_aaoag020-B28","doi-asserted-by":"publisher","first-page":"907","DOI":"10.1016\/j.rmed.2011.01.008","volume":"105","author":"Mohamed Hoesein","year":"2011","journal-title":"Lower Limit of Normal or FEV1\/FVC &lt; 0.70 in Diagnosing COPD: An Evidence-Based Review Respir Med"},{"key":"2026071404060147500_aaoag020-B29","doi-asserted-by":"publisher","first-page":"2401603","DOI":"10.1183\/13993003.01603-2024","article-title":"GOLD Science Committee recommendations for the use of pre- and post-bronchodilator spirometry for the diagnosis of COPD","volume":"65","author":"Singh","year":"2025","journal-title":"European Respiratory Journal"}],"container-title":["Annals of the American Thoracic Society"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/annalsats\/advance-article-pdf\/doi\/10.1093\/annalsats\/aaoag020\/67063532\/aaoag020.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/annalsats\/article-pdf\/23\/6\/873\/67063532\/aaoag020.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/annalsats\/article-pdf\/23\/6\/873\/67063532\/aaoag020.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T08:06:08Z","timestamp":1784016368000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/annalsats\/article\/23\/6\/873\/8494359"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,21]]},"references-count":29,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2026,2,21]]},"published-print":{"date-parts":[[2026,6,1]]}},"URL":"https:\/\/doi.org\/10.1093\/annalsats\/aaoag020","relation":{},"ISSN":["2329-6933","2325-6621"],"issn-type":[{"value":"2329-6933","type":"print"},{"value":"2325-6621","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,6]]},"published":{"date-parts":[[2026,2,21]]}}}