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Validity and interpretation of spirometric recordings to diagnose COPD in UK primary care

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Title: Validity and interpretation of spirometric recordings to diagnose COPD in UK primary care
Authors: Rothnie, K
Chandan, JS
Goss, HG
Müllerová, H
Quint, JK
Item Type: Journal Article
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. 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. 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. 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.
Issue Date: 7-Jun-2017
Date of Acceptance: 27-Mar-2017
URI: http://hdl.handle.net/10044/1/46116
DOI: https://dx.doi.org/10.2147/COPD.S133891
ISSN: 1176-9106
Publisher: Dove Medical Press
Start Page: 1663
End Page: 1668
Journal / Book Title: International Journal of Chronic Obstructive Pulmonary Disease
Volume: 12
Copyright Statement: © 2017 Rothnie et al. This work is published by Dove Medical Press Limited, and licensed under a Creative Commons Attribution License. The full terms of the License are available at http://creativecommons.org/licenses/by/4.0/. The license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Sponsor/Funder: GlaxoSmithKline Services Unlimited
Funder's Grant Number: PO #3000793769
Keywords: Respiratory System
1102 Cardiovascular Medicine And Haematology
Publication Status: Published
Appears in Collections:National Heart and Lung Institute
Faculty of Medicine



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