Table 1.

Key drivers of the under-recognition of AATD.

Driver	Additional information
Poor knowledge of AATD by physicians	• In a web-based survey comprising 30 multiple-choice questions aimed at testing the knowledge of physicians and respiratory therapists about AATD, respondents answered only approximately 50% of questions correctly.16
	• In another survey, only 14% of respondents reported “knowing very well” about AATD.17
Underappreciation of and non-compliance with guidelines by physicians	• A literature study identified a number of common potential barriers to guideline adherence, including lack of familiarity and awareness of guidelines, self-efficacy, outcome expectancy, and inability to overcome the inertia of previous practice.18
	• Another study found that it is not always clear to primary care physicians when to test for AATD, or when to refer patients to a specialist.19
“Therapeutic nihilism”	• The incorrect belief that therapy is not available has been reported.20

AATD, alpha-1 antitrypsin deficiency.