Priority 2 from the COPD Exacerbation PSP

UNCERTAINTY: What is the best way to tell the start of an exacerbation from day-to day variation in symptoms? (JLA PSP Priority 2)
Overall ranking	2
JLA question ID	0104/2
Explanatory note	An exacerbation of COPD is associated with a worsening of symptoms. However, people living with COPD often have symptoms which vary from day to day. Helping people to be able to tell the difference between the start of an exacerbations, and day-to-day variation in symptoms would be a big step forward.
Evidence	The question has not been addressed in the evidence base
Health Research Classification System category	Respiratory

Extra information provided by this PSP
Original uncertainty examples	How does a doctor know its COPD flare or not.~ When to recognise the start of flare ups ~ How can I tell if I have an imminent infection sometimes it seems to come on without my knowing and it is harder to get rid of? ~ How to recognise the signs ~ how to be sure it is an exacerbation and not just "a bad day" ~ How is this diagnosed ~ How do you know if you’re having an exacerbation or a chest infection what are the differences? ~ Is there always chest tightness? ~ Is there always a rise in temperature?~ What are the symptoms they look at ~ Is there a biomarker that helps diagnose COPD exacerbation? ~ Is there a biomarker that predicts COPD exacerbation?
Submitted by	Patient, Carer, Relative, Healthcare professional

Extra information provided by this PSP

Original uncertainty examples

How does a doctor know its COPD flare or not.~ When to recognise the start of flare ups ~ How can I tell if I have an imminent infection sometimes it seems to come on without my knowing and it is harder to get rid of? ~ How to recognise the signs ~ how to be sure it is an exacerbation and not just "a bad day" ~ How is this diagnosed ~ How do you know if you’re having an exacerbation or a chest infection what are the differences? ~ Is there always chest tightness? ~ Is there always a rise in temperature?~ What are the symptoms they look at ~ Is there a biomarker that helps diagnose COPD exacerbation? ~ Is there a biomarker that predicts COPD exacerbation?

Submitted by

Patient, Carer, Relative, Healthcare professional

PSP information
PSP unique ID	0104
PSP name	COPD Exacerbation PSP
Total number of uncertainties identified by this PSP.	51 (To see a full list of all uncertainties identified, please see the detailed spreadsheet held on the JLA website)
Date of priority setting workshop	1 April 2021