Background: Spirometry is increasingly implemented in general practice, while the ability of general practitioners (GPs) to interpret flow volume curves (F-V curves) has been questioned. Furthermore, the role of spirometry in the GPs decision-making process has barely been studied.
Aim: To compare the achievements of trained GPs in spirometric diagnosis with an expert consensus panel (1) and to assess the influence of spirometry on the GPs decision-making (2).
Method: Twelve cases including a wide range of F-V curves were interpreted by 39 GPs as well as the expert panel. Diagnostic test characteristics were calculated using multi-level analysis and summarised by diagnostic odds ratios (DOR). Differences in decision-making indicators were expressed as odds ratios and 95% confidence intervals.
Results: Normal F-V curves (DOR 65.0) and obstructive F-V curves (DOR 48.9) were reasonably well diagnosed, while rare and mixed pathological patterns achieved considerably lower scores (DOR 3.8). Intermediate scores were obtained in the recognition of incorrect test manoeuvres (DOR 24.4). Spirometry influenced the GPs decision-making in reducing the number of alternative diagnoses (OR 0.266 [0.200, 0.353]), but also increased referral rates (7.26 [4.71, 11.2]) and the use of diagnostic prednisolone courses (4.55 [3.12, 6.64]) substantially.
Conclusion: Trained GPs were able to differentiate between normal and obstructive disease patterns, while F-V curves suggestive of rare and mixed pathology were often missed. Spirometry seems to influence the decision-making process of the GP; whether this represents an initial or a more sustained effect remains to be evaluated in studies of daily primary care practice.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.rmed.2004.04.004 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Physiological, Photosynthetic Characteristic and Transcriptome Analysis of Transgenic × Under Salt Stress.
Int J Mol Sci
December 2024
College of Forestry, Henan Agricultural University, Zhengzhou 450002, China.
The WRKY70 transcription factor (TF) was reported to play an important role in the salt stress response mechanism of in our previous research, and we also produced several overexpression (OEXs) and RNAi suppression (REXs) × lines. In order to further compare the photosynthetic and physiological characteristics of NT (non-transgenic line) and transgenic lines under salt stress, the dynamic phenotypic change, Na and K content in leaf and root tissues, superoxide dismutase (SOD) and peroxidase (POD) activity, malondialdehyde (MDA) content, chlorophyll content (Chl), photosynthesis parameters (net photosynthetic rate, P; stomatal conductance, Gs; intercellular CO concentration, C; transpiration rate, T), chlorophyll fluorescence parameters (electron transport rate, ETR; maximum photochemical efficiency of photosystem II (PSII), F/F; actual efficiency of PSII, Φ; photochemical quenching coefficient, q; non-photochemical quenching, NPQ; the photosynthetic light-response curves of Φ and ETR) and RNA-seq of NT, OEX and REX lines were detected and analyzed. The phenotypic observation, MDA content and Chl detection results indicate that the stress damage of REXs was less severe than that of NT and OEX lines under salt stress.
View Article and Find Full Text PDFAssessment of 3-Cyanobenzoic Acid as a Possible Herbicide Candidate: Effects on Maize Growth and Photosynthesis.
Plants (Basel)
December 2024
Laboratory of Plant Biochemistry, Department of Biochemistry, State University of Maringá, Maringá 87020-900, Brazil.
Chemical weed control is a significant agricultural concern, and reliance on a limited range of herbicide action modes has increased resistant weed species, many of which use C4 metabolism. As a result, the identification of novel herbicidal agents with low toxicity targeting C4 plants becomes imperative. An assessment was conducted on the impact of 3-cyanobenzoic acid on the growth and photosynthetic processes of maize (), a representative C4 plant, cultivated hydroponically over 14 days.
View Article and Find Full Text PDFThe effect of temperature on rates of dissolved organic carbon (DOC) release by the kelp Ecklonia radiata (phylum Ochrophyta): Implications for the future coastal ocean carbon cycle.
J Phycol
December 2024
Institute for Marine and Antarctic Studies (IMAS), University of Tasmania (UTAS), Battery Point, Tasmania, Australia.
Dissolved organic carbon (DOC) released by macroalgae is an intrinsic component of the coastal ocean carbon cycle, yet knowledge of how future ocean warming may influence this is limited. Temperature is one of the primary abiotic regulators of macroalgal physiology, but there is minimal understanding of how it influences the magnitude and mechanisms of DOC release. To investigate this, we examined the effect of a range of temperatures on DOC release rates and physiological traits of Ecklonia radiata, the most abundant and widespread kelp in Australia that represents a potentially significant contribution to coastal ocean carbon cycling.
View Article and Find Full Text PDFAssociations Between Contrast Sensitivity, Optical Coherence Tomography Features and Progression From Intermediate to Late Age-related Macular Degeneration.
Am J Ophthalmol
November 2024
From the Harvard Retinal Imaging Lab (C.B., F.R., F.V., M.G., X.D., A.B., I.P., I.S., K.O., G.B., I.G., J.R., I.L., L.A. K., and J.B.M.), Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, USA; Department of Ophthalmology (F.R., X.D., D.N., G.B., R.B., I.L., L.A. K., D.V., D.H., J.W.M., and J.B. M.), Retina Service, Massachusetts Eye and Ear, Boston, Massachusetts, USA. Electronic address:
Article Synopsis
- This study explores the relationships between OCT biomarkers and contrast sensitivity in eyes diagnosed with intermediate age-related macular degeneration (iAMD), aiming to improve understanding of disease progression.
- A total of 205 eyes from 134 patients were analyzed; findings reveal that higher retinal pigment epithelium volume and intraretinal hyperreflective foci correlate with poorer contrast sensitivity measures.
- Over a follow-up period, approximately 43% of eyes progressed to late-stage AMD, indicating the potential clinical significance of the identified biomarkers in predicting progression.
Discovery of Plasma Lipids as Potential Biomarkers Distinguishing Breast Cancer Patients from Healthy Controls.
Int J Mol Sci
October 2024
BCAL Diagnostics Ltd., Sydney, NSW 2000, Australia.
The development of a sensitive and specific blood test for the early detection of breast cancer is crucial to improve screening and patient outcomes. Existing methods, such as mammography, have limitations, necessitating the exploration of alternative approaches, including circulating factors. Using 598 prospectively collected blood samples, a multivariate plasma-derived lipid biomarker signature was developed that can distinguish healthy control individuals from those with breast cancer.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!