Findings on Thoracic Computed Tomography Scans and Respiratory Outcomes in Persons with and without Chronic Obstructive Pulmonary Disease: A Population-Based Cohort Study
Thoracic computed tomography (CT) scans are widely performed in clinical practice, often leading to detection of airway or parenchymal abnormalities in asymptomatic or minimally symptomatic individuals. However, clinical relevance of CT abnormalities is uncertain in the general population. We evalua...
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| Published in | PloS one Vol. 11; no. 11; p. e0166745 |
|---|---|
| Main Authors | , , , , , , , , , , , , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
United States
Public Library of Science
18.11.2016
Public Library of Science (PLoS) |
| Subjects | |
| Online Access | Get full text |
| ISSN | 1932-6203 1932-6203 |
| DOI | 10.1371/journal.pone.0166745 |
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| Abstract | Thoracic computed tomography (CT) scans are widely performed in clinical practice, often leading to detection of airway or parenchymal abnormalities in asymptomatic or minimally symptomatic individuals. However, clinical relevance of CT abnormalities is uncertain in the general population.
We evaluated data from 1361 participants aged ≥40 years from a Canadian prospective cohort comprising 408 healthy never-smokers, 502 healthy ever-smokers, and 451 individuals with spirometric evidence of chronic obstructive pulmonary disease (COPD) who had thoracic CT scans. CT images of subjects were visually scored for respiratory bronchiolitis(RB), emphysema(E), bronchial-wall thickening(BWT), expiratory air-trapping(AT), and bronchiectasis(B). Multivariable logistic regression models were used to assess associations of CT features with respiratory symptoms, dyspnea, health status as determined by COPD assessment test, and risk of clinically significant exacerbations during 12 months follow-up.
About 11% of life-time never-smokers demonstrated emphysema on CT scans. Prevalence increased to 30% among smokers with normal lung function and 36%, 50%, and 57% among individuals with mild, moderate or severe/very severe COPD, respectively. Presence of emphysema on CT was associated with chronic cough (OR,2.11; 95%CI,1.4-3.18); chronic phlegm production (OR,1.87; 95% CI,1.27-2.76); wheeze (OR,1.61; 95% CI,1.05-2.48); dyspnoea (OR,2.90; 95% CI,1.41-5.98); CAT score≥10(OR,2.17; 95%CI,1.42-3.30) and risk of ≥2 exacerbations over 12 months (OR,2.17; 95% CI, 1.42-3.0).
Burden of thoracic CT abnormalities is high among Canadians ≥40 years of age, including never-smokers and smokers with normal lung function. Detection of emphysema on CT scans is associated with pulmonary symptoms and increased risk of exacerbations, independent of smoking or lung function. |
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| AbstractList | Background Thoracic computed tomography (CT) scans are widely performed in clinical practice, often leading to detection of airway or parenchymal abnormalities in asymptomatic or minimally symptomatic individuals. However, clinical relevance of CT abnormalities is uncertain in the general population. Methods We evaluated data from 1361 participants aged [greater than or equal to]40 years from a Canadian prospective cohort comprising 408 healthy never-smokers, 502 healthy ever-smokers, and 451 individuals with spirometric evidence of chronic obstructive pulmonary disease (COPD) who had thoracic CT scans. CT images of subjects were visually scored for respiratory bronchiolitis(RB), emphysema(E), bronchial-wall thickening(BWT), expiratory air-trapping(AT), and bronchiectasis(B). Multivariable logistic regression models were used to assess associations of CT features with respiratory symptoms, dyspnea, health status as determined by COPD assessment test, and risk of clinically significant exacerbations during 12 months follow-up. Results About 11% of life-time never-smokers demonstrated emphysema on CT scans. Prevalence increased to 30% among smokers with normal lung function and 36%, 50%, and 57% among individuals with mild, moderate or severe/very severe COPD, respectively. Presence of emphysema on CT was associated with chronic cough (OR,2.11; 95%CI,1.4-3.18); chronic phlegm production (OR,1.87; 95% CI,1.27-2.76); wheeze (OR,1.61; 95% CI,1.05-2.48); dyspnoea (OR,2.90; 95% CI,1.41-5.98); CAT score[greater than or equal to]10(OR,2.17; 95%CI,1.42-3.30) and risk of [greater than or equal to]2 exacerbations over 12 months (OR,2.17; 95% CI, 1.42-3.0). Conclusions Burden of thoracic CT abnormalities is high among Canadians [greater than or equal to]40 years of age, including never-smokers and smokers with normal lung function. Detection of emphysema on CT scans is associated with pulmonary symptoms and increased risk of exacerbations, independent of smoking or lung function. Thoracic computed tomography (CT) scans are widely performed in clinical practice, often leading to detection of airway or parenchymal abnormalities in asymptomatic or minimally symptomatic individuals. However, clinical relevance of CT abnormalities is uncertain in the general population. We evaluated data from 1361 participants aged ≥40 years from a Canadian prospective cohort comprising 408 healthy never-smokers, 502 healthy ever-smokers, and 451 individuals with spirometric evidence of chronic obstructive pulmonary disease (COPD) who had thoracic CT scans. CT images of subjects were visually scored for respiratory bronchiolitis(RB), emphysema(E), bronchial-wall thickening(BWT), expiratory air-trapping(AT), and bronchiectasis(B). Multivariable logistic regression models were used to assess associations of CT features with respiratory symptoms, dyspnea, health status as determined by COPD assessment test, and risk of clinically significant exacerbations during 12 months follow-up. About 11% of life-time never-smokers demonstrated emphysema on CT scans. Prevalence increased to 30% among smokers with normal lung function and 36%, 50%, and 57% among individuals with mild, moderate or severe/very severe COPD, respectively. Presence of emphysema on CT was associated with chronic cough (OR,2.11; 95%CI,1.4-3.18); chronic phlegm production (OR,1.87; 95% CI,1.27-2.76); wheeze (OR,1.61; 95% CI,1.05-2.48); dyspnoea (OR,2.90; 95% CI,1.41-5.98); CAT score≥10(OR,2.17; 95%CI,1.42-3.30) and risk of ≥2 exacerbations over 12 months (OR,2.17; 95% CI, 1.42-3.0). Burden of thoracic CT abnormalities is high among Canadians ≥40 years of age, including never-smokers and smokers with normal lung function. Detection of emphysema on CT scans is associated with pulmonary symptoms and increased risk of exacerbations, independent of smoking or lung function. Thoracic computed tomography (CT) scans are widely performed in clinical practice, often leading to detection of airway or parenchymal abnormalities in asymptomatic or minimally symptomatic individuals. However, clinical relevance of CT abnormalities is uncertain in the general population.BACKGROUNDThoracic computed tomography (CT) scans are widely performed in clinical practice, often leading to detection of airway or parenchymal abnormalities in asymptomatic or minimally symptomatic individuals. However, clinical relevance of CT abnormalities is uncertain in the general population.We evaluated data from 1361 participants aged ≥40 years from a Canadian prospective cohort comprising 408 healthy never-smokers, 502 healthy ever-smokers, and 451 individuals with spirometric evidence of chronic obstructive pulmonary disease (COPD) who had thoracic CT scans. CT images of subjects were visually scored for respiratory bronchiolitis(RB), emphysema(E), bronchial-wall thickening(BWT), expiratory air-trapping(AT), and bronchiectasis(B). Multivariable logistic regression models were used to assess associations of CT features with respiratory symptoms, dyspnea, health status as determined by COPD assessment test, and risk of clinically significant exacerbations during 12 months follow-up.METHODSWe evaluated data from 1361 participants aged ≥40 years from a Canadian prospective cohort comprising 408 healthy never-smokers, 502 healthy ever-smokers, and 451 individuals with spirometric evidence of chronic obstructive pulmonary disease (COPD) who had thoracic CT scans. CT images of subjects were visually scored for respiratory bronchiolitis(RB), emphysema(E), bronchial-wall thickening(BWT), expiratory air-trapping(AT), and bronchiectasis(B). Multivariable logistic regression models were used to assess associations of CT features with respiratory symptoms, dyspnea, health status as determined by COPD assessment test, and risk of clinically significant exacerbations during 12 months follow-up.About 11% of life-time never-smokers demonstrated emphysema on CT scans. Prevalence increased to 30% among smokers with normal lung function and 36%, 50%, and 57% among individuals with mild, moderate or severe/very severe COPD, respectively. Presence of emphysema on CT was associated with chronic cough (OR,2.11; 95%CI,1.4-3.18); chronic phlegm production (OR,1.87; 95% CI,1.27-2.76); wheeze (OR,1.61; 95% CI,1.05-2.48); dyspnoea (OR,2.90; 95% CI,1.41-5.98); CAT score≥10(OR,2.17; 95%CI,1.42-3.30) and risk of ≥2 exacerbations over 12 months (OR,2.17; 95% CI, 1.42-3.0).RESULTSAbout 11% of life-time never-smokers demonstrated emphysema on CT scans. Prevalence increased to 30% among smokers with normal lung function and 36%, 50%, and 57% among individuals with mild, moderate or severe/very severe COPD, respectively. Presence of emphysema on CT was associated with chronic cough (OR,2.11; 95%CI,1.4-3.18); chronic phlegm production (OR,1.87; 95% CI,1.27-2.76); wheeze (OR,1.61; 95% CI,1.05-2.48); dyspnoea (OR,2.90; 95% CI,1.41-5.98); CAT score≥10(OR,2.17; 95%CI,1.42-3.30) and risk of ≥2 exacerbations over 12 months (OR,2.17; 95% CI, 1.42-3.0).Burden of thoracic CT abnormalities is high among Canadians ≥40 years of age, including never-smokers and smokers with normal lung function. Detection of emphysema on CT scans is associated with pulmonary symptoms and increased risk of exacerbations, independent of smoking or lung function.CONCLUSIONSBurden of thoracic CT abnormalities is high among Canadians ≥40 years of age, including never-smokers and smokers with normal lung function. Detection of emphysema on CT scans is associated with pulmonary symptoms and increased risk of exacerbations, independent of smoking or lung function. Background Thoracic computed tomography (CT) scans are widely performed in clinical practice, often leading to detection of airway or parenchymal abnormalities in asymptomatic or minimally symptomatic individuals. However, clinical relevance of CT abnormalities is uncertain in the general population. Methods We evaluated data from 1361 participants aged ≥40 years from a Canadian prospective cohort comprising 408 healthy never-smokers, 502 healthy ever-smokers, and 451 individuals with spirometric evidence of chronic obstructive pulmonary disease (COPD) who had thoracic CT scans. CT images of subjects were visually scored for respiratory bronchiolitis(RB), emphysema(E), bronchial-wall thickening(BWT), expiratory air-trapping(AT), and bronchiectasis(B). Multivariable logistic regression models were used to assess associations of CT features with respiratory symptoms, dyspnea, health status as determined by COPD assessment test, and risk of clinically significant exacerbations during 12 months follow-up. Results About 11% of life-time never-smokers demonstrated emphysema on CT scans. Prevalence increased to 30% among smokers with normal lung function and 36%, 50%, and 57% among individuals with mild, moderate or severe/very severe COPD, respectively. Presence of emphysema on CT was associated with chronic cough (OR,2.11; 95%CI,1.4–3.18); chronic phlegm production (OR,1.87; 95% CI,1.27–2.76); wheeze (OR,1.61; 95% CI,1.05–2.48); dyspnoea (OR,2.90; 95% CI,1.41–5.98); CAT score≥10(OR,2.17; 95%CI,1.42–3.30) and risk of ≥2 exacerbations over 12 months (OR,2.17; 95% CI, 1.42–3.0). Conclusions Burden of thoracic CT abnormalities is high among Canadians ≥40 years of age, including never-smokers and smokers with normal lung function. Detection of emphysema on CT scans is associated with pulmonary symptoms and increased risk of exacerbations, independent of smoking or lung function. Thoracic computed tomography (CT) scans are widely performed in clinical practice, often leading to detection of airway or parenchymal abnormalities in asymptomatic or minimally symptomatic individuals. However, clinical relevance of CT abnormalities is uncertain in the general population. We evaluated data from 1361 participants aged [greater than or equal to]40 years from a Canadian prospective cohort comprising 408 healthy never-smokers, 502 healthy ever-smokers, and 451 individuals with spirometric evidence of chronic obstructive pulmonary disease (COPD) who had thoracic CT scans. CT images of subjects were visually scored for respiratory bronchiolitis(RB), emphysema(E), bronchial-wall thickening(BWT), expiratory air-trapping(AT), and bronchiectasis(B). Multivariable logistic regression models were used to assess associations of CT features with respiratory symptoms, dyspnea, health status as determined by COPD assessment test, and risk of clinically significant exacerbations during 12 months follow-up. About 11% of life-time never-smokers demonstrated emphysema on CT scans. Prevalence increased to 30% among smokers with normal lung function and 36%, 50%, and 57% among individuals with mild, moderate or severe/very severe COPD, respectively. Presence of emphysema on CT was associated with chronic cough (OR,2.11; 95%CI,1.4-3.18); chronic phlegm production (OR,1.87; 95% CI,1.27-2.76); wheeze (OR,1.61; 95% CI,1.05-2.48); dyspnoea (OR,2.90; 95% CI,1.41-5.98); CAT score[greater than or equal to]10(OR,2.17; 95%CI,1.42-3.30) and risk of [greater than or equal to]2 exacerbations over 12 months (OR,2.17; 95% CI, 1.42-3.0). Burden of thoracic CT abnormalities is high among Canadians [greater than or equal to]40 years of age, including never-smokers and smokers with normal lung function. Detection of emphysema on CT scans is associated with pulmonary symptoms and increased risk of exacerbations, independent of smoking or lung function. Background Thoracic computed tomography (CT) scans are widely performed in clinical practice, often leading to detection of airway or parenchymal abnormalities in asymptomatic or minimally symptomatic individuals. However, clinical relevance of CT abnormalities is uncertain in the general population. Methods We evaluated data from 1361 participants aged ≥40 years from a Canadian prospective cohort comprising 408 healthy never-smokers, 502 healthy ever-smokers, and 451 individuals with spirometric evidence of chronic obstructive pulmonary disease (COPD) who had thoracic CT scans. CT images of subjects were visually scored for respiratory bronchiolitis(RB), emphysema(E), bronchial-wall thickening(BWT), expiratory air-trapping(AT), and bronchiectasis(B). Multivariable logistic regression models were used to assess associations of CT features with respiratory symptoms, dyspnea, health status as determined by COPD assessment test, and risk of clinically significant exacerbations during 12 months follow-up. Results About 11% of life-time never-smokers demonstrated emphysema on CT scans. Prevalence increased to 30% among smokers with normal lung function and 36%, 50%, and 57% among individuals with mild, moderate or severe/very severe COPD, respectively. Presence of emphysema on CT was associated with chronic cough (OR,2.11; 95%CI,1.4–3.18); chronic phlegm production (OR,1.87; 95% CI,1.27–2.76); wheeze (OR,1.61; 95% CI,1.05–2.48); dyspnoea (OR,2.90; 95% CI,1.41–5.98); CAT score≥10(OR,2.17; 95%CI,1.42–3.30) and risk of ≥2 exacerbations over 12 months (OR,2.17; 95% CI, 1.42–3.0). Conclusions Burden of thoracic CT abnormalities is high among Canadians ≥40 years of age, including never-smokers and smokers with normal lung function. Detection of emphysema on CT scans is associated with pulmonary symptoms and increased risk of exacerbations, independent of smoking or lung function. |
| Audience | Academic |
| Author | Maltais, Francois Road, Jeremy Leipsic, Jonathon Li, Pei Z. Hernandez, Paul Aaron, Shawn D. Hague, Cameron J. Cowie, Robert Hogg, James C. Sin, Don D. FitzGerald, J. Mark Bourbeau, Jean Zheng, Liyun Raju, Rekha Marciniuk, Darcy D. O’Donnell, Denis E. Tan, Wan C. Kirby, Miranda Chapman, Kenneth R. Coxson, Harvey O. |
| AuthorAffiliation | 2 Department of Radiology, St. Paul's Hospital, University of British Columbia, Vancouver, BC, Canada 4 University of British Columbia, Vancouver General Hospital, Institute for Heart and Lung Health, Vancouver, BC, Canada 1 Center for Heart Lung Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, BC, Canada 3 Respiratory Epidemiology and Clinical Research Unit, Montreal Chest Institute, McGill University, Montréal, QC, Canada 5 Division of Respiratory & Critical Care Medicine, Queen’s University, Kingston, ON, Canada 7 Division of Respirology, QEII Health Sciences Centre, Dalhousie University, Halifax, Nova Scotia, Canada National and Kapodistrian University of Athens, SWITZERLAND 6 Hospital Laval, Centre de Pneumologie, Institute Universitaire de Cardiologie et de Pneumologie de Quebec, Universite Laval, Quebec, QC, Canada 8 Departments of Medicine and Community Health Sciences, University of Calgary, Calgary, Alberta, Canada 11 Ottawa Hospital Research Institute, Univ |
| AuthorAffiliation_xml | – name: 7 Division of Respirology, QEII Health Sciences Centre, Dalhousie University, Halifax, Nova Scotia, Canada – name: National and Kapodistrian University of Athens, SWITZERLAND – name: 8 Departments of Medicine and Community Health Sciences, University of Calgary, Calgary, Alberta, Canada – name: 9 Asthma & Airway Centre, University Health Network, Toronto, ON, Canada – name: 10 Division of Respirology, Critical Care and Sleep Medicine, and Airway research Group, University of Saskatchewan, Saskatoon, SK, Canada – name: 2 Department of Radiology, St. Paul's Hospital, University of British Columbia, Vancouver, BC, Canada – name: 3 Respiratory Epidemiology and Clinical Research Unit, Montreal Chest Institute, McGill University, Montréal, QC, Canada – name: 1 Center for Heart Lung Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, BC, Canada – name: 4 University of British Columbia, Vancouver General Hospital, Institute for Heart and Lung Health, Vancouver, BC, Canada – name: 6 Hospital Laval, Centre de Pneumologie, Institute Universitaire de Cardiologie et de Pneumologie de Quebec, Universite Laval, Quebec, QC, Canada – name: 11 Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada – name: 5 Division of Respiratory & Critical Care Medicine, Queen’s University, Kingston, ON, Canada |
| Author_xml | – sequence: 1 givenname: Wan C. surname: Tan fullname: Tan, Wan C. – sequence: 2 givenname: Cameron J. surname: Hague fullname: Hague, Cameron J. – sequence: 3 givenname: Jonathon surname: Leipsic fullname: Leipsic, Jonathon – sequence: 4 givenname: Jean surname: Bourbeau fullname: Bourbeau, Jean – sequence: 5 givenname: Liyun surname: Zheng fullname: Zheng, Liyun – sequence: 6 givenname: Pei Z. surname: Li fullname: Li, Pei Z. – sequence: 7 givenname: Don D. surname: Sin fullname: Sin, Don D. – sequence: 8 givenname: Harvey O. surname: Coxson fullname: Coxson, Harvey O. – sequence: 9 givenname: Miranda surname: Kirby fullname: Kirby, Miranda – sequence: 10 givenname: James C. surname: Hogg fullname: Hogg, James C. – sequence: 11 givenname: Rekha surname: Raju fullname: Raju, Rekha – sequence: 12 givenname: Jeremy surname: Road fullname: Road, Jeremy – sequence: 13 givenname: Denis E. surname: O’Donnell fullname: O’Donnell, Denis E. – sequence: 14 givenname: Francois surname: Maltais fullname: Maltais, Francois – sequence: 15 givenname: Paul surname: Hernandez fullname: Hernandez, Paul – sequence: 16 givenname: Robert surname: Cowie fullname: Cowie, Robert – sequence: 17 givenname: Kenneth R. surname: Chapman fullname: Chapman, Kenneth R. – sequence: 18 givenname: Darcy D. surname: Marciniuk fullname: Marciniuk, Darcy D. – sequence: 19 givenname: J. Mark surname: FitzGerald fullname: FitzGerald, J. Mark – sequence: 20 givenname: Shawn D. surname: Aaron fullname: Aaron, Shawn D. |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/27861566$$D View this record in MEDLINE/PubMed |
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| ContentType | Journal Article |
| Copyright | COPYRIGHT 2016 Public Library of Science 2016 Tan et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. 2016 Tan et al 2016 Tan et al |
| Copyright_xml | – notice: COPYRIGHT 2016 Public Library of Science – notice: 2016 Tan et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. – notice: 2016 Tan et al 2016 Tan et al |
| CorporateAuthor | Canadian Respiratory Research Network and the CanCOLD Collaborative Research group |
| CorporateAuthor_xml | – name: Canadian Respiratory Research Network and the CanCOLD Collaborative Research group |
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| DOI | 10.1371/journal.pone.0166745 |
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| Notes | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 content type line 23 Competing Interests: DDM, JCH, JMF, DOD, MK, CJH, RR, RC, SA, PL, and LZ have no conflict to declare. JL reports consultancy for CT scans vendors GE, Samsung, and Philips. DDS reports personal fees from Almirall, AstraZeneca, Amgen, and Novatis, and grants from AstraZeneca, outside the submitted work. FM reports grants and personal fees from GSK, Boehringer Ingelheim, and Novartis, and grants from Nycomed, and AstraZeneca during the conduct of the study. KRC reports grants from Novartis, Almirall, Boehringer Ingelheim, Forest, GSK, AstraZeneca, Amgen, Roche, CSL Behring, Grifols, Genentech, and Kamada, during the conduct of the study; and other from CIHR-GSK Research Chair in Respiratory Health Care Delivery, outside the submitted work. PH has received fees for delivering accredited CME and/or consultancy on advisory board for AstraZeneca, Boehringer Ingelheim, Bayer, CSL Behring, Grifols, GlaxoSmithKline, Merck, Novartis, Roche. Dr.Hernandez's institution has received funding for conducting research from Boehringer Ingelheim, Grifols, and CSL Behring. HOC reports personal fees from GSK, and Samsung, and grants from GSK, and Spiration Inc, outside the submitted work. JB and WCT report grants from the Canadian Institute of Heath Research (CIHR/Rx&D Collaborative Research Program Operating Grants- 93326) with industry partners Astra Zeneca Canada Ltd., Boehringer-Ingelheim Canada Ltd, GlaxoSmithKline Canada Ltd, Merck, Novartis Pharma Canada Inc., Nycomed Canada Inc., and Pfizer Canada Ltd., during the conduct of the study. This does not alter our adherence to PLOS ONE policies on sharing data and materials. Conceptualization: WCT JB JH.Data curation: WCT JB PZL LZ JCH HOC MK JL CJH.Formal analysis: WCT DDS PZL LZ MK.Funding acquisition: JB WCT.Investigation: WCT JB JMF RC KRC PH SDA DDM DEO FM CJH JL RR MK HOC JR.Methodology: WCT JB JCH HOC.Project administration: WCT JB HOC.Resources: WCT JB HOC JL CJH JCH.Software: HOC.Supervision: WCT JB.Validation: WCT JB JCH.Visualization: WCT LZ PZL DDS.Writing – original draft: WCT DDS.Writing – review & editing: WCT JB JMF RC KRC PH SDA DDM DEO FM CJH JL RR PZL LZ MK HOC JR JCH DDS. Membership of the CanCOLD Collaborative Research Group is listed in the Acknowledgments. |
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| Snippet | Thoracic computed tomography (CT) scans are widely performed in clinical practice, often leading to detection of airway or parenchymal abnormalities in... Background Thoracic computed tomography (CT) scans are widely performed in clinical practice, often leading to detection of airway or parenchymal abnormalities... BACKGROUND:Thoracic computed tomography (CT) scans are widely performed in clinical practice, often leading to detection of airway or parenchymal abnormalities... Background Thoracic computed tomography (CT) scans are widely performed in clinical practice, often leading to detection of airway or parenchymal abnormalities... |
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| SubjectTerms | Abnormalities Adult Aged Aged, 80 and over Airway management Asthma Biology and Life Sciences Bronchiectasis Bronchopneumonia Canada - epidemiology CAT scans Chronic obstructive lung disease Chronic obstructive pulmonary disease Cohort analysis Cohort Studies Collaboration Computation Computed tomography Cough Critical care Dyspnea Emphysema Epidemiology Female Health sciences Heart Hospitals Humans Lung diseases Male Medical imaging Medical research Medicine and Health Sciences Middle Aged Obstructive lung disease Odds Ratio Outcome Assessment, Health Care Physiology Population Population studies Population Surveillance Population-based studies Prevalence Pulmonary Disease, Chronic Obstructive - diagnostic imaging Pulmonary Disease, Chronic Obstructive - epidemiology Pulmonary Disease, Chronic Obstructive - physiopathology Quality of life Radiology Regression analysis Regression models Research and Analysis Methods Respiration Respiratory function Respiratory Function Tests Respiratory tract Self Report Severity of Illness Index Smokers Smoking Thickening Thorax Tomography, X-Ray Computed Yang, Cindy |
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| Title | Findings on Thoracic Computed Tomography Scans and Respiratory Outcomes in Persons with and without Chronic Obstructive Pulmonary Disease: A Population-Based Cohort Study |
| URI | https://www.ncbi.nlm.nih.gov/pubmed/27861566 https://www.proquest.com/docview/1841403080 https://www.proquest.com/docview/1841801827 https://www.proquest.com/docview/1846416121 https://pubmed.ncbi.nlm.nih.gov/PMC5115801 https://doaj.org/article/1f122fb4862d412bbc906bc599b63326 http://dx.doi.org/10.1371/journal.pone.0166745 |
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