Related Experiment Videos
The validity of diagnostic support of an asthma/COPD service in primary care
Annelies Lucas1, Frank Smeenk, Ivo Smeele
1Primary Care Heath Care Centre 'Orion', Eindhoven, The Netherlands. Annelies.Lucas@Hag.unimaas.nl
Background:
To support GPs in diagnosing and monitoring their patients with asthma/chronic obstructive pulmonary disease (COPD), 'asthma/COPD services' have been developed. Within these services, pulmonologists perform structured diagnostic and therapeutic assessments based on the combination of written history data and spirometry.
Aim:
This study determines the validity of the diagnosis and advice when assessed using only written information.
Design Of Study:
The results of the diagnostic procedures of an asthma/COPD service were compared with the results of regular office consultations by pulmonologists.
Setting:
From January until August 2004, two pulmonologists examined 80 randomly selected patients referred to an asthma/COPD service in Eindhoven, the Netherlands.
Method:
Concordance was analysed between diagnosis and advice based on written spirometry and history data, with assessments based on live consultations with the same patients by pulmonologists.
Results:
The validity of the assessed diagnosis was high (Cohen's kappa = 0.82). When the diagnosis was uncertain, the advice for medical treatment scored low in validity (Cohen's kappa = 0.39). The advice for additional diagnostic examinations had a high internal validity: in half of the patients, uncertainty in diagnosis turned into a definite diagnosis of asthma/COPD, or another cause for the complaints of the patient was revealed; in the other half, the diagnosis of asthma/COPD could be rejected.
Conclusions:
A structured asthma/COPD service offering diagnosis and diagnostic advice assessed from written spirometry and history data is a new and valid facility that can support the GP who faces the complicated diagnostic procedures in a progressive number of patients with asthma/COPD.
Related Concept Videos
Chronic Obstructive Pulmonary Disease-IV: Assessement and Diagnostic Studies
Medical History
COPD: Management Using Bronchodilators and Corticosteroids
Asthma-IV: Diagnostic and Management
Clinical Assessment for Asthma:
This is the first step in diagnosing and managing asthma. It includes:
Chronic Obstructive Pulmonary Disease-I: Introduction
Chronic Obstructive Pulmonary Disease
Smoking is a primary risk factor for COPD, with over 80% of patients having a history of it. Patients typically experience progressive dyspnea or labored breathing, frequent coughing, and recurrent pulmonary infections. Many eventually succumb to respiratory failure, characterized by...
Chronic Obstructive Pulmonary Disease-V: Management
Smoking Cessation