Terapevticheskii arkhivTerapevticheskii arkhiv0040-36602309-5342LLC Obyedinennaya Redaktsiya10823410.26442/00403660.2022.04.201487Review ArticleProblems and opportunities to improve diagnosis of asthma and chronic obstructive pulmonary disease in Russia: resolution of advisory boardAvdeevSergey N.emelav@inbox.ruhttps://orcid.org/0000-0002-5999-2150EmelyanovAlexander V.emelav@inbox.ruhttps://orcid.org/0000-0002-8574-6869AisanovZaurbek R.emelav@inbox.ruhttps://orcid.org/0000-0002-4044-674XSinopalnikovAlexander I.emelav@inbox.ruhttps://orcid.org/0000-0002-1990-2042FominaDaria S.emelav@inbox.ruhttps://orcid.org/0000-0002-5083-6637NenashevaNatalia M.emelav@inbox.ruhttps://orcid.org/0000-0002-3162-2510LeshchenkoIgor V.emelav@inbox.ruhttps://orcid.org/0000-0002-1620-7159Zaikova-KhelimskaiaIrina V.emelav@inbox.ruhttps://orcid.org/0000-0002-7517-4027VizelAlexander A.emelav@inbox.ruhttps://orcid.org/0000-0001-5028-5276DemkoIrina V.emelav@inbox.ruhttps://orcid.org/0000-0001-8982-5292ShaporovaNataliia L.emelav@inbox.ruhttps://orcid.org/0000-0002-6457-5044ShulzhenkoLarisa V.emelav@inbox.ruhttps://orcid.org/0000-0002-2110-0970ShabanovEvgeny A.emelav@inbox.ruhttps://orcid.org/0000-0002-5790-4196Sechenov First Moscow State Medical University (Sechenov University)Mechnikov North-Western State Medical UniversityPirogov Russian National Research Medical UniversityRussian Medical Academy of Continuous Professional EducationCity Clinical Hospital №52Ural State Medical UniversityFar Eastern State Medical UniversityKazan State Medical UniversityVoyno-Yasenetsky Krasnoyarsk Medical UniversityPavlov First Saint Petersburg State Medical UniversityResearch Institute – Ochapovsky Regional Clinical Hospital №1Kuban State Medical UniversityKursk Regional Multidisciplinary Clinical Hospital260520229445245292505202225052022Copyright © 2022, Consilium Medicum2022<p>Asthma and chronic obstructive pulmonary disease remain major problems of medicine, and still there is need to improve the level and quality of diagnosis of these diseases. Primary care physicians (general practitioners, therapists) should be involved widely and actively in this process. To simplify the diagnosis, special questionnaires have been developed, they can be used in a real clinical practice. Only this approach will bring statistical data closer to the true prevalence of these diseases and improve quality of their treatment.</p>asthmachronic obstructive pulmonary diseasediagnosisбронхиальная астмахроническая обструктивная болезнь легкихдиагностика[Быстрицкая Е.В., Биличенко Т.Н. Заболеваемость, инвалидность и смертность от болезней органов дыхания в Российской Федерации (2015–2019). Пульмонология. 2021;31(5):551-61 [Bystritskaya EV, Bilichenko TN. The morbidity, disability, and mortality associated with respiratory diseases in the Russian Federation (2015–2019). Pulmonologiya. 2021;31(5):551-61 (in Russian)]. DOI:10.18093/0869-0189-2021-31-5-551-561][Авдеев С.Н., Ненашева Н.М., Жуденков К.В., и др. Распространенность, заболеваемость, фенотипы и другие характеристики тяжелой бронхиальной астмы в Российской Федерации. Пульмонология. 2018;28(3):341-58 [Avdeev SN, Nenasheva NM, Zhudenkov KV, et al. Prevalence, morbidity, phenotypes and other characteristics of severe bronchial asthma in Russian Federation. Pulmonologiya. 2018;28(3):341-58 (in Russian)]. DOI:10.18093/0869-0189-2018-28-3-341-358][Клинические рекомендации «Бронхиальная астма» 2021 г. Российское респираторное общество (РРО). Режим доступа: https://cr.minzdrav.gov.ru/ Ссылка активна на 04.02.2022 [Clinical recommendations “Bronchial asthma” 2021. Russian Respiratory Society (RRS). Available at: https://cr.minzdrav.gov.ru/. Accessed: 04.02.2022 (in Russian)].][Заболеваемость всего населения России в 2019 году. Статистические материалы. Часть II. ФГБУ «Центральный научно-исследовательский институт организации и информатизации здравоохранения» Минздрава России. М., 2020 [Zabolevaemost' vsego naseleniia Rossii v 2019 godu. Statisticheskie materialy, Chast' II. FGBU “Central'nyi nauchno-issledovatel'skii institut organizatsii i informatizatsii zdravoohraneniia” Minzdrava Rossii. Moscow, 2020 (in Russian)].][Авдеев С.Н., Айсанов З.Р., Белевский А.С., и др. Пути улучшения диагностики и лечения больных бронхиальной астмой врачами первичного звена. Пульмонология. 2019;29(4):457-67 [Avdeev SN, Aisanov SR, Belevskiy AS, et al. A strategy for improvement in diagnosis and treatment of bronchial asthma in primary care. Pulmonologiya. 2019;29(4):457-67 (in Russian)]. DOI:10.18093/0869-0189-2019-29-4-457-467][Архипов В.В., Айсанов З.P., Авдеев C.Н. Эффективность комбинаций ингаляционных глюкокортикостероидов и длительно действующих β-агонистов в условиях реальной медицинской практики: результаты многоцентрового кросс-секционного исследования у российских пациентов с бронхиальной астмой. Пульмонология. 2021;31(5):613-26 [Arkhipov VV, Aisanov ZR, Avdeev SN. Effectiveness of inhaled corticosteroids and long-acting β-agonists combinations in real clinical practice: results of a multicenter cross-sectional study in Russian patients with asthma. Pulmonologiya. 2021;31(5):613-26 (in Russian)]. DOI:10.18093/0869-0189-2021-31-5-613-626][From the Global Strategy for Asthma Management and Prevention, Global Initiative for Asthma (GINA) 2021. Available at: http://www.ginasthma.org. Accessed: 04.02.2022.][Авдеев С.Н., Айсанов З.Р., Архипов В.В., и др. Роль и значение ингаляционных глюкокортикостероидов у пациентов с хронической обструктивной болезнью легких: современные рекомендации. Заключение совета экспертов. Пульмонология. 2019;29(5):632-6 [Avdeev SA, Aisanov ZR, Arkhipov VV, et al. A role of inhaled corticosteroids in management of patients with chronic obstructive pulmonary disease: current recommendations. Expert panel conclusion. Pulmonologiya. 2019;29(5):632-6 (in Russian)]. DOI:10.18093/0869-0189-2019-29-5-632-636][Global Initiative for Chronic Obstructive Lung Disease. Global Strategy for Diagnosis, Management, and Prevention of Chronic Obstructive Lung Disease. 2019 Report. Available at: https://goldcopd.org/wp-content/uploads/2018/11/GOLD-2019-v1.7-FINAL-14Nov2018-WMS.pdf. Accessed: 11.01.2022.][World Health Organization. The top 10 causes of death. Available at: https://www.who.int/news-room/fact-sheets/detail/the-top-10-causes-of-death. Accessed: 11.01.2022.][Adeloye D, Chua S, Lee C, et al. Global and regional estimates of COPD prevalence: Systematic review and meta-analysis. J Glob Health. 2015;5(2):020415. DOI:10.7189/jogh.05-020415][GBD 2013 Mortality and Causes of Death Collaborators. Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2015;385(9963):117-71. DOI:10.1016/S0140-6736(14)61682-2][Lopez AD, Shibuya K, Rao C, et al. Obstructive pulmonary disease: current burden and future projections. Eur Respir J. 2006;27(2):397-412. DOI:10.1183/09031936.06.00025805][World Health Organization. Projections of mortality and causes of death, 2015 and 2030. Available at: https://www.who.int/healthinfo/global_burden_disease/projections2015_2030/en/ Accessed: 11.01.2022.][Andreeva E, Pokhaznikova M, Lebedev A, et al. The Prevalence of Chronic Obstructive Pulmonary Disease by the Global Lung Initiative Equations in North-Western Russia. Respiration. 2016;91(1):43-55. DOI:10.1159/000442887][Клинические рекомендации «Хроническая обструктивная болезнь легких» 2021 г. Российское респираторное общество (РРО). Режим доступа: https://cr.minzdrav.gov.ru/schema/603_2. Ссылка активна на 29.03.2022 [Clinical guidelines “Chronic obstructive pulmonary disease” 2021 Russian Respiratory Society (RRS). Available at: https://cr.minzdrav.gov.ru/schema/603_2. Accessed: 11.01.2022 (in Russian)].][Arkhipov V, Arkhipova D, Miravitlles M, et al. Characteristics of COPD patients according to GOLD classification and clinical phenotypes in the Russian Federation: the SUPPORT trial. Int J Chron Obstruct Pulmon Dis. 2017;12:3255-62. DOI:10.2147/COPD.S142997][Концевая А.В., Муканеева Д.К., Баланова Ю.А., и др. Экономический ущерб от болезней органов дыхания и хронической обструктивной болезни легких в Российской Федерации в 2016 году. Пульмонология. 2019;29(2):159-66 [Kontsevaya AV, Mukaneyeva DK, Balanova YuA, et al. Economic burden of respiratory diseases and chronic obstructive pulmonary disease in Russian Federation, 2016. Pulmonologiya. 2019;29(2):159-66 (in Russian)]. DOI:10.18093/0869-0189-2019-29-2-159-166][Mannino DM, Sonia Buist A, Vollmer WM. Chronic obstructive pulmonary disease in the older adult: what defines abnormal lung function? Thorax. 2007;62(3):237-41. DOI:10.1136/thx.2006.068379][Aaron SD, Tan WC, Bourbeau J, et al. Diagnostic Instability and Reversals of Chronic Obstructive Pulmonary Disease Diagnosis in Individuals with Mild to Moderate Airflow Obstruction. Am J Respir Crit Care Med. 2017;196(3):306-14. DOI:10.1164/rccm.201612-2531OC][DeWeerdt S, Grouse L. Chronic Airways Diseases: A Guide for Primary Care Physicians. 2005.][Decramer M, Cooper CB. Treatment of COPD: the sooner the better? Thorax. 2010;65(9):837-41. DOI:10.1136/thx.2009.133355; PMID: 20805184][Han MK, Agusti A, Celli BR, et al. From GOLD 0 to Pre-COPD. Am J Respir Crit Care Med. 2021;203(4):414-23. DOI:10.1164/rccm.202008-3328PP][Kaplan A, Cao H, Fitzgerald JM, et al. Asthma/COPD Differentiation Classification (AC/DC): Machine Learning to Aid Physicians in Diagnosing Asthma, COPD and Asthma-COPD Overlap (ACO). DOI:10.1164/ajrccm-conference.2020.201.1_MeetingAbstracts.A6285][Topalovic M, Das N, Burgel PR, et al. Artificial intelligence outperforms pulmonologists in the interpretation of pulmonary function tests. Eur Respir J. 2019;53(4):1801660. DOI:10.1183/13993003.01660-2018][Ramos Hernández C, Núñez Fernández M, Pallares Sanmartín A, et al. Validation of the portable Air-Smart Spirometer. PLoS One. 2018;13(2):e0192789. DOI:10.1371/journal.pone.0192789]