Priority 3 from the COPD Exacerbation PSP

UNCERTAINTY: What is the best way to tell the difference between an exacerbation and a different cause of changing symptoms in a person with COPD?  (JLA PSP Priority 3)
Overall ranking 3
JLA question ID 0104/3
Explanatory note Not every change in symptoms in a person with COPD represents an exacerbation - there can be other causes too, for example pneumonia, blood clots on the lung or a problem with the heart.  This question addresses how best to tell the difference between an exacerbation and changes in symptoms due to these other causes. 
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 can a COPD exacerbation be differentiated from other causes of breathlessness?~ how do we tell if someone is exacerbating with infection/ bacteria or if symptoms are driven by anxiety ~ How can patients be assisted in identifying COPD exacerbation when they have multi-morbidity that may give similar symptoms?~ How do we distinguish between anxiety and an exacerbation?  
Submitted by 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