Quality of spirometry and related diagnosis in primary care with a focus on clinical use.

Quality of spirometry and related diagnosis in primary care with a focus on clinical use. NPJ Prim Care Respir Med. 2020 May 15;30(1):22 Authors: van de Hei SJ, Flokstra-de Blok BMJ, Baretta HJ, Doornewaard NE, van der Molen T, Patberg KW, Ruberg ECM, Schermer TRJ, Steenbruggen I, van den Berg JWK, Kocks JWH Abstract American and European societies' (ATS/ERS) criteria for spirometry are often not met in primary care. Yet, it is unknown if quality is sufficient for daily clinical use. We evaluated quality of spirometry in primary care based on clinical usefulness, meeting ATS/ERS criteria and agreement on diagnosis between general practitioners (GPs) and pulmonologists. GPs included ten consecutive spirometry tests and detailed history questionnaires of patients who underwent spirometry as part of usual care. GPs and two pulmonologists assessed the spirometry tests and questionnaires on clinical usefulness and formulated a diagnosis. In total, 149 participants covering 15 GPs were included. Low agreements were found on diagnosis between GPs and pulmonologists 1 (κ = 0.39) and 2 (κ = 0.44). GPs and pulmonologists rated >88% of the tests as clinically useful, although 13% met ATS/ERS criteria. This real-life study demonstrated that clinical usefulness of routine primary care spirometry tests was high, although agreement on diagnosis was low. PMID: 32415077 [PubMed - in process]
Source: Primary Care - Category: Primary Care Authors: Tags: NPJ Prim Care Respir Med Source Type: research