An observational study from Greece which analysed 5,226 participants found that underdiagnosis, false diagnosis, and poor treatment outcome in the primary care setting is high and often inconsistent with Global Initiative for the Chronic Obstructive Lung Disease (GOLD) guidelines. The researchers found that more than half of the COPD patients in the cohort were underdiagnosed and a number of the correctly diagnosed patients were overtreated when compared against the GOLD guidelines. Study results indicated that more than 50 percent of patients with COPD were underdiagnosed, more than 50 percent of patients with a previous correct diagnosis of COPD were overtreated, and most patients on treatment with inhaled drugs and respiratory symptoms in the primary care setting were falsely diagnosed and treated as patients with COPD. The researchers of the study, published in European Journal of General Medicine, highlighted the continuing problem of underdiagnosis in the case of COPD patients and suggested practitioners also take into account other modes of diagnosis such as spirometry to get a concrete diagnosis.