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Validity and interpretation of spirometric recordings to diagnose COPD in UK primary care.
- Source :
-
International journal of chronic obstructive pulmonary disease [Int J Chron Obstruct Pulmon Dis] 2017 Jun 07; Vol. 12, pp. 1663-1668. Date of Electronic Publication: 2017 Jun 07 (Print Publication: 2017). - Publication Year :
- 2017
-
Abstract
- Background: The diagnosis of COPD is dependent upon clinical judgment and confirmation of the presence of airflow obstruction using spirometry. Spirometry is now routinely available; however, spirometry incorrectly performed or interpreted can lead to misdiagnosis. We aimed to determine whether spirometry undertaken in primary care for patients suspected to have COPD was of sufficient quality and whether their spirometry was correctly interpreted.<br />Methods: Two chest physicians re-read all spirometric readings for both quality of the procedure and interpretation, received as a part of COPD validation studies using data from the Clinical Practice Research Datalink (CPRD). We then used logistic regression to investigate predictors of correct interpretation.<br />Results: Spirometry traces were obtained for 306 patients, of which 221 (72.2%) were conducted in primary care. Of those conducted in primary care, 98.6% (n=218) of spirometry traces were of adequate quality. Of those traces that were of adequate quality and conducted in primary care, and in whom a general practitioner (GP) diagnosis of COPD had been made, 72.5% (n=218) were consistent with obstruction. Historical records for asthma diagnosis significantly decreased odds of correct interpretation.<br />Conclusion: The quality of the spirometry procedure undertaken in primary care is high. However, this was not reflected in the quality of interpretation, suggesting an unmet training in primary care. The quality of the spirometry procedure as demonstrated by spirometric tracings provides a re-assurance for the use of spirometric values available in the electronic health care record databases for research purposes.<br />Competing Interests: Disclosure HM is employed by GSK R&D and owns shares and stock options of GlaxoSmithKline Plc. The other authors report no conflicts of interest in this work.
- Subjects :
- Aged
Databases, Factual
Electronic Health Records
Female
Humans
Logistic Models
Male
Middle Aged
Observer Variation
Odds Ratio
Predictive Value of Tests
Pulmonary Disease, Chronic Obstructive physiopathology
Quality Indicators, Health Care
Reproducibility of Results
Severity of Illness Index
United Kingdom
Lung physiopathology
Primary Health Care
Pulmonary Disease, Chronic Obstructive diagnosis
Spirometry standards
Subjects
Details
- Language :
- English
- ISSN :
- 1178-2005
- Volume :
- 12
- Database :
- MEDLINE
- Journal :
- International journal of chronic obstructive pulmonary disease
- Publication Type :
- Academic Journal
- Accession number :
- 28652719
- Full Text :
- https://doi.org/10.2147/COPD.S133891