Spirometry in primary care: is it good enough to face demands like World COPD Day?: Table 1

Schermer, Tjard; Eaton, Tam; Pauwels, Romain; Weel, Chris van

doi:10.1183/09031936.03.00075203

Cited by 22 publications

(20 citation statements)

References 10 publications

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“…Failures in general practice are predominantly end-of-test related (underestimation of FVC and overestimation of FEV 1/FVC ratio). 26 In a telephone-based study in the UK, 27 GPs were more confident about diagnosing COPD in 2005 than in 2001 (80% vs 52%). However, their self-reported confidence was not in accordance with the diagnoses, investigations and management strategies they proposed on case scenarios.…”

Section: Discussionmentioning

confidence: 99%

A combination of the IPAG questionnaire and PiKo-6® flow meter is a valuable screening tool for COPD in the primary care setting

Sichletidis

Spyratos

Papaioannou

et al. 2011

Primary Care Respiratory Journal

131

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Aims: To investigate the validity of the International Primary Care Airways Guidelines (IPAG) questionnaire and PiKo-6 ® (Ferraris Respiratory Europe Ltd.) flow meter as screening tools for diagnosing chronic obstructive pulmonary disease (COPD) in the primary care setting. Methods:The first 50 patients in 25 general practice offices completed the IPAG questionnaire and underwent spirometry with the handheld PiKo-6 ® flow meter. The results were compared with official spirometry parameters after bronchodilation. All participants had no previous medical diagnosis of respiratory diseases.Results: Data from 1,078 out of 1,250 subjects (462 males, mean age 65.3±11.4 years) were analysed. The percentage of smokers was 48.4% (38±29 pack-years). COPD was diagnosed in 111 (10.3%) patients. In the subgroup of smokers the sensitivity and specificity for COPD diagnosis were 91% and 49%, respectively, for the IPAG questionnaire; 80% and 95% respectively for the PiKo-6 ® spirometer; and 72% and 97% for their combination. The negative predictive value of the questionnaire was 97%, whereas the positive predictive value of the questionnaire/ PiKo-6 ® combination was 82%. Using a cut-off score of 19 points for the IPAG questionnaire, we calculated the best combination of sensitivity (75%) and specificity (72%). Conclusions:The IPAG questionnaire and the hand-held PiKo-6 ® spirometer can be used in combination to increase the possibility of an early and accurate diagnosis of COPD in the primary care setting.

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Section: Discussionmentioning

confidence: 99%

A combination of the IPAG questionnaire and PiKo-6® flow meter is a valuable screening tool for COPD in the primary care setting

Sichletidis

Spyratos

Papaioannou

et al. 2011

Primary Care Respiratory Journal

131

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“…It is of note that relevant clinical guidelines indicate the need for a widespread use of spirometry in primary care for early detection and appropriate management of asthma and chronic obstructive pulmonary disease (COPD). There is, however, a great deal of controversy [5][6][7][8] regarding the quality of the tests performed in primary care by nonexpert professionals, resulting in suboptimal deployment of FS. Consequently, effective training of healthcare professionals ensuring high quality of FS in primary care is crucial to generate reliable results preventing unnecessary test duplications across the healthcare system.…”

mentioning

confidence: 99%

Telemedicine enhances quality of forced spirometry in primary care

Burgos¹,

Disdier²,

Santamaria³

et al. 2011

Eur Respir J

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Forced spirometry is pivotal for diagnosis and management of respiratory diseases, but its use in primary care is suboptimal. The aim of the present study was to assess a web-based application aiming at fostering high-quality spirometry in primary care.This was a randomised controlled trial with 12 intervention primary care units (PCi) and six control units (PCc) studied over 12 months. All 34 naïve nurses (PCi and PCc) received identical training. The PCi units had access to educational material and remote expert support. Quality of spirometry and usability of the web application were assessed.We included 4,581 patients (3,383 PCi and 1,198 PCc). At baseline, quality was similar (PCi 71% and PCc 67% high-quality tests). During the study, PCi showed higher percentage (71.5%) of highquality tests than PCc (59.5%) (p,0.0001). PCi had 73% more chance of high-quality performance than PCc. The web application was better for assessing quality of testing than the automatic feedback provided by the spirometer. Healthcare professionals' satisfaction and usability were high.The web-based remote support for primary care by specialists generated a sustained positive impact on quality of testing. The study expands the potential of primary care for diagnosis and management of patients with pulmonary diseases.

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“…9,10 Moreover, the validity of spirometry findings and their utility in the management of patients with COPD to date are unclear and questionable. [11][12][13][14][15] Moreover, spirometry cannot be performed on all patients. Haynes 16 reported the inability of subjects to exhale for Ն 6 s as the most common reason, whereas Hardie et al 17 reported a variety of other reasons for spirometry failure.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic Utility of Biomarkers in COPD

Ambade¹,

Sontakke

Barthwal³

et al. 2015

Respir Care

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BACKGROUND: COPD will become the third leading cause of death by 2020. There are many situations in which spirometry, the primary tool for diagnosis of COPD, cannot be performed, and thus, the staging and status of these patients cannot be determined. To date, there is no known biochemical marker used for diagnosing COPD. This study aimed to explore the utility of biomarkers for diagnosis of COPD. METHODS: This was an observational study composed of 96 stable subjects with COPD and 96 subjects with normal lung function. Each group contained an equal number of smokers and nonsmokers. Serum levels of superoxide dismutase 3, glutathione peroxidase, catalase, ceruloplasmin ferroxidase activity, C-reactive protein, and surfactant protein D (SPD) were estimated. Ferroxidase activity was estimated by a kinetic method, whereas the other analytes were measured by enzyme-linked immunosorbent assay. The cutoff value, sensitivity and specificity at the cutoff value, and area under the curve for each analyte were determined from receiver operating characteristic curve. RESULTS: Significantly decreased superoxide dismutase 3 and increased ferroxidase activity, SPD, glutathione peroxidase, and C-reactive protein levels were found in subjects with COPD. For all subjects and nonsmoking subjects with COPD, the area under the curve was highest for ferroxidase activity, followed by glutathione peroxidase, SPD, and C-reactive protein, with a sensitivity and specificity of > 73%. For smoking subjects with COPD, the area under the curve was highest for SPD, followed by glutathione peroxidase, ferroxidase activity, and C-reactive protein, with a sensitivity and specificity > 67%. Some combinations of markers were found to give either a sensitivity or specificity of > 95%, which can be utilized to rule in and rule out COPD. CONCLUSIONS: Biomarkers can be reliably utilized in the diagnosis of COPD. Of all the markers, SPD appears to be the most promising in smokers, whereas ferroxidase activity shows promise in nonsmokers. To rule out COPD, ferroxidase activity or glutathione peroxidase can be potentially useful, whereas to rule in COPD, ferroxidase activity and glutathione peroxidase appear to be the most promising combination in both nonsmoking and smoking subjects.

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Spirometry in primary care: is it good enough to face demands like World COPD Day?: Table 1

Cited by 22 publications

References 10 publications

A combination of the IPAG questionnaire and PiKo-6® flow meter is a valuable screening tool for COPD in the primary care setting

A combination of the IPAG questionnaire and PiKo-6® flow meter is a valuable screening tool for COPD in the primary care setting

Telemedicine enhances quality of forced spirometry in primary care

Diagnostic Utility of Biomarkers in COPD

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