Evaluation of internists’ spirometric interpretations

Hnatiuk, Oleh W.; Moores, Lisa K.; Loughney, Thomas M.; Torrington, Kenneth G.

doi:10.1007/bf02642476

Cited by 26 publications

(19 citation statements)

References 10 publications

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“…18 In another study, interns and respiratory specialists reached 58% agreement. 19 The concordance we found in this study (mean κ=0.64) was comparable -which is remarkable since the respiratory specialists combined the interpretation of medical history and spirometry data thus making the assessment more complicated. When compared to other complicated diagnostic procedures such as chest radiograph interpretation by pulmonologists (κ=0.51), 20 the diagnostic reliability of the assessments in our study is not inadequate.…”

Section: Comparable Diagnostic Assessments Of Asthma/copdsupporting

confidence: 72%

Diagnostic assessments of spirometry and medical history data by respiratory specialists supporting primary care: are they reliable?

Lucas

Smeenk

Borne

et al. 2009

Primary Care Respiratory Journal

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Aim: To determine the intra-and inter-observer reliability of respiratory specialists' diagnostic assessments of spirometry and written medical history data obtained from primary care.Method: Five respiratory specialists assessed spirometry data and the history of 156 patients randomly selected from referrals to an asthma/COPD-service. The inter-observer reliability was evaluated. After six months, all specialists repeated the assessments and the intraobserver reliability was evaluated.Results: The diagnostic assessments for all patients had reasonable intra-and inter-observer reliability, resulting in a Cohen's kappa (κ) of 0.67 and 0.66 respectively. The intra-observer reliability for assessing the need for additional diagnostic examinations had an average κ 0.56 for new patients and an average κ 0.39 for follow-up examinations. The assessments of clinical stability in follow-up patients -on which therapeutic advice was based -were inconsistent. Conclusion:GPs who are reluctant to perform or interpret spirometry themselves may be supported diagnostically by respiratory specialists in an asthma/COPD-service. The reliability of this advice varies. More appropriate criteria for assessing clinical stability in patients with asthma and COPD are necessary to improve the reliability of the therapeutic advice.

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Section: Comparable Diagnostic Assessments Of Asthma/copdsupporting

confidence: 72%

Diagnostic assessments of spirometry and medical history data by respiratory specialists supporting primary care: are they reliable?

Lucas

Smeenk

Borne

et al. 2009

Primary Care Respiratory Journal

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show abstract

“…A recent survey of primary care physicians' spirometry interpretations found that one third of tests were interpreted incorrectly. 23 Even after a focused, albeit brief, workshop, participants in our study still felt uncomfortable with interpretation. Fortunately, one study has shown computerized interpretation algorithms to be accurate in 92% of spirograms.…”

Section: Discussionmentioning

confidence: 77%

Knowledge and use of office spirometry for the detection of chronic obstructive pulmonary disease by primary care physicians

Kaminsky

Marcy

Bachand

et al. 2006

Respiratory Medicine: COPD Update

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BACKGROUND: The importance of office spirometry has been strongly advocated in the pulmonary community, but whether its importance is recognized and accepted by primary care physicians is less well established. METHODS: To assess primary care physicians' knowledge and use of office spirometry for the detection of chronic obstructive pulmonary disease, we conducted a brief mail survey on the local practice of office spirometry, barriers to performing office spirometry, and general knowledge about spirometry. We also provided 60-min educational workshops to assess whether such an approach would increase spirometry testing or perceptions about spirometry. RESULTS: Twenty-nine of 57 (51%) primary care offices responded to the survey. Of these, 66% owned their own spirometer. The most common reasons for not performing spirometry were uncertainty about the impact of the test (41%), physician and staff unfamiliarity (38%), and lack of training (34%). Twenty-one respondents participated in the workshops. In the 3 months following the workshops, the number of spirometry tests increased by 59% (p ‫؍‬ 0.004). After the workshops, the proportion of clinics that reported reasons for not performing the test decreased by 13% (p ‫؍‬ 0.01), but important barriers to performing office spirometry were still present, including physician and staff unfamiliarity (22%), uncertain interpretation of results (22%), time (22%), and reimbursement (22%). CONCLUSIONS: The general knowledge and use of office spirometry in the primary care community is poor, but can be improved, at least in the short-term, by a simple educational workshop.

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“…Similar questions about generalists' care have been asked in other medical fields, including cardiology and pulmonary medicine. [7][8][9][10][11][12] The study and discussion of these questions, however, usually miss the point. Experience rather than board certification may be the critical component necessary to providing quality care.…”

Section: Specialty-related or Experience-related?mentioning

confidence: 99%

Quality in HIV/AIDS Care: Specialty-Related or Experience-Related?

Feyler¹

1997

J GEN INTERN MED

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Evaluation of internists’ spirometric interpretations

Cited by 26 publications

References 10 publications

Diagnostic assessments of spirometry and medical history data by respiratory specialists supporting primary care: are they reliable?

Diagnostic assessments of spirometry and medical history data by respiratory specialists supporting primary care: are they reliable?

Knowledge and use of office spirometry for the detection of chronic obstructive pulmonary disease by primary care physicians

Quality in HIV/AIDS Care: Specialty-Related or Experience-Related?

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