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Chronic obstructive pulmonary disease (COPD) is an important, and increasing, cause of disability and death around the world (1-3). Despite being a major disease, it still is often not identified by name in most developed countries. For example, in the United States the estimate of prevalent cases of COPD is made by asking people about chronic bronchitis or emphysema (4). Cultural and societal differences can also influence the perceived prevalence of a disease. In Korea, COPD is not a well known term by the public or the medical community (5). The term "haeso cheonsik," which means "cough and dyspnea," is much more familiar to the Korean population (5). Haeso cheonsik, which could mean COPD, asthma, heart failure, or a variety of other diseases, is thought to be part of the "normal" aging process and is frequently accepted, without medical consultation, as part of growing old (5).
In the current issue of the Journal (pp. 842-847), Kim and colleagues report on the prevalence of COPD in Korea using data from the 2nd Korean National Health and Nutritional Examination Survey, which had adequate spirometry data from 3,981 subjects (43.1% of the 9,243 subjects sampled) (6). They used a modification of the Global Initiative on Obstructive Lung Disease (GOLD) criteria to classify subjects (7). Bronchodilators were not administered, so all lung function measurements were "pre-bronchodilator," and their main criteria for the presence of COPD was an FEV^sub 1^/FVC of less than 0.70, corresponding to GOLD Stage 1 or more severe COPD. Overall, they found that 7.8% of the studied population had GOLD Stage 1 or more severe COPD. This study demonstrates many of the challenges of measuring the burden of lung disease in a population, with both similarities and differences to those seen in other parts of the world.
Measuring lung function in populations is challenging because obtaining high-quality...