Tag Archives: Medscape

Will the Kitsap County Health District Get Involved?

A office Spirometer costs about $800. At least one Kitsap County resident has pledged to donate the machine to the KCHD – Will the Kitsap County Health District – Finally – Play Early Detection Spirometry?

WHEN will the Kitsap County Health District (KCHD) get concerned with early detection Spirometry testing for COPD (Chronic Obstructive Pulmonary Disease) the 4th leading cause of death in the country?

120,000 people die each year from COPD …many of them could have been stopped in its tracks by early detection.

Thanks to Steve Nelson we know Kitsap County has about 9,200 diagnosed COPDers. This slow developing disease takes about twenty years to develop symptoms enough to tell the doctor. The educated guess is that another 9,200 or more are undetected. A Spirometry test could save lives and millions in public funds to medically treat COPDers and other diseases that may develop after COPD opens the door.

The KCHD’s stated online Program Goal in part:

“Community Health Promotion carries out the Health District’s mission by developing and implementing culturally competent outreach and educational programs and policies to positively influence health behavior and health choices among Kitsap County residents.

* Community mobilization;
* Coalition development and collaboration with external
* Health education intervention planning, implementation, and evaluation;
* Utilization of social marketing strategies;
* Utilizing a strength-based (asset framework).

Community Health Promotion areas of focus include:

* Tobacco Prevention and Control;
* Injury Prevention;
* Kitsap Gets Active;
* Outreach to Hispanic Families;
* Adolescent Health Education;
* Breast and Cervical Health;…”


Where is early detection Spirometry testing for COPD?

The KCHD is involved with Breast and Cervical Health when COPD kills more people per year than Breast and Lung Cancer combined.
COPD is ignored.

‘Tobacco Prevention and Control’ is listed. 80% of COPDers were smokers.

KCHD ignores COPD early detection.

Medscape says:

“… Several well-recognized criteria have been established for the use of medical tests that have been proposed for the early detection of disease, [30-34] and spirometry for the detection of COPD in adult cigarette smokers fulfills all of these criteria:

1. The disease, if not detected early, would go on to cause substantial morbidity or mortality;

2. Treatment is available that is more effective when used at the early stage before the development of symptoms than when used after the symptoms develop; and

3. A feasible testing and follow-up strategy is available that
a. minimizes the false-positive and false-negative rates,
b. is relatively simple and affordable,
c. uses a safe test, and
d. includes an action plan that minimizes potential adverse effects.

The above criteria are usually applied to screening tests, defined as medical tests done for individuals who have no symptoms or signs that suggest the possibility of disease.

Office spirometry is considered to be a part of a clinical evaluation and does not fall under the definition of a screening test when performed for patients with respiratory symptoms who are seen during a clinical encounter (whether or not they have a history of cigarette smoking). Also, if the patient has been diagnosed as having tobacco addiction (a disease with a code in the International Classification of Diseases, ninth revision), office spirometry may be indicated to assess the severity of that disease and is not then considered to be a screening test. Although the NLHEP does not recommend office spirometry for screening unselected populations or for testing patients who have no cardiopulmonary risk factors, the next section of this document provides evidence that office spirometry fulfills all of the criteria listed above when it is used to detect COPD in adult smokers.

The Disease, If Not Detected Early, Would Go On to Cause Substantial Morbidity or Mortality

Office Spirometry Is Relatively Simple and Affordable

Spirometry is a relatively simple, noninvasive test. Office spirometry takes only a few minutes of the patient’s and technician’s time and includes a few athletic-type breathing maneuvers of 6 s duration. The economic costs of a spirometry test include the cost of the instrument and the cost of personnel time (both training and testing). Diagnostic spirometers currently cost about $2,000, and about $10 of time per test is spent in testing (including training time) and disposable supplies. Office spirometers will cost , $800 and require even less testing time than diagnostic spirometers. Adding a post-bronchodilator spirometry test for asthma adds about 15 min to the test time (but is not needed for COPD evaluations).

COPD is the most important lung disease encountered and the fourth leading cause of death in the United States, and it affects at least 16 million people.[7,35] Of the top causes of mortality in the United States, only the death rate for COPD continues to rise, increasing by 22% in the past decade. The 10-year mortality rate for COPD after diagnosis is > 50%.[36] In addition, the number of patients with COPD has doubled in the last 25 years, with the prevalence of COPD now rising faster in women than in men.[37] Although the frequency of hospitalization for many illnesses is decreasing, the number of hospital discharges for COPD rose in the last decade. COPD causes 50 million days per year of bed disability and 14 million days per year of restricted activity.[38,39] COPD causes about 100,000 deaths per year, 550,000 hospitalizations per year, 16 million office visits per year, and $13 billion per year in medical costs, including home care.[35]

Treatment Is Available That Is More Effective When Used at the Early Stage of COPD, Before the Development of Symptoms, Than When Used After Symptoms Develop

COPD is a slowly progressive, chronic disease …”


Part 1 More later…. Sharon O’Hara