Lung Foundation

The sensitivity of physical examination for detecting mild to moderate COPD is poor.¹ Wheezing is not an indicator of severity of disease and is often absent in stable, severe COPD. In more advanced disease, physical features commonly found are hyperinflation of the chest, reduced chest expansion, hyperresonance to percussion, soft breath sounds and a prolonged expiratory phase. 

Spirometry is the gold standard for diagnosing, assessing and monitoring COPD.

The presence and severity of airflow limitation are impossible to determine by clinical signs. Objective measurements such as spirometry are strongly recommended. Peak expiratory flow (PEF) is not a sensitive measure of airway function in COPD patients, as it is effort dependent and has a wide range of normal values.

1. COPD-X Guidelines www.copdx.org.au