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. 2024 Mar 13;11(1):e002203. doi: 10.1136/bmjresp-2023-002203

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© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

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Schematic diagram for the execution of the hospital-based cohort study. This hospital-based cohort study adopted a design of ambispective cohort. Each EMR is regarded as a follow-up. As shown in trajectory 1, for some participants who only have one EMR, we conducted follow-up spirometry and serum urate test in the month of June 2022 for them. Similarly, as shown in trajectory 2, we conducted a follow-up work in the month of June 2022 for participants who had not been diagnosed as COPD in the final EMR. As shown in trajectory 3, when the EMRs first showed that the participant was diagnosed with COPD, we considered this EMR as the occurrence of outcome. COPD, chronic obstructive pulmonary disease; EMR, electronic medical record.