Should chest examination be reinstated in the early diagnosis of chronic obstructive pulmonary disease?

Although proven to be associated with bronchial obstruction, chest signs are not listed among cues that should prompt spirometry in the early diagnosis of chronic obstructive pulmonary disease (COPD) in established guidelines. We aimed to explore how chest findings add to respiratory symptoms and a history of smoking in the diagnosis of COPD. In a cross-sectional study, patients aged 40 years or older, previously diagnosed with either asthma or COPD in primary care, answered questionnaires and underwent physical chest examination and spirometry. Among the 375 patients included, 39.7% had forced expiratory volume in 1 second/forced vital capacity