| Does a decision aid help physicians to detect chronic obstructive pulmonary disease? | |
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MedLine Citation:
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PMID: 22152850 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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Background Numerous decision aids have been developed recently, but the value they add above that of the initial clinical assessment is not well known. Aim To quantify whethera formal decision aid for chronic obstructive pulmonary disease (COPD) adds diagnostic information, above the physician's clinical assessment. Design and setting Subanalysis of a diagnostic study in Dutch primary care. Method Sixty-five primary care physicians included 357 patients who attended for persistent cough and were not known to have COPD. The physicians estimated the probability of COPD after short history taking and physical examination. After this, the presence or absence of COPD was determined using results of extensive diagnostic work-up. The extent to which an 8-item decision aid for COPD, which included only symptoms and signs, added diagnostic value above the physician's estimation was quantified by the increase of the area under the receiver operating characteristic curve (ROC area), and the improvement in diagnostic risk classification across two classes: 'low probability of COPD' (<20%) and 'possible COPD' (≥20%). Results One hundred and four patients (29%) had COPD. Adding the decision aid to the clinical assessment increased the ROC area from 0.75 (95% confidence interval [CI] = 0.70 to 0.81) to 0.84 (95% CI = 0.80 to 0.89) (P<0.005), and improved the diagnostic risk classification of the patients, such that 35 fewer patients needed spirometry testing and eight fewer COPD cases were missed. Conclusion A short decision aid for COPD added diagnostic value to the physician's clinical assessment. |
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Authors:
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Berna Dl Broekhuizen; Alfred Sachs; Kristel Janssen; Geert-Jan Geersing; Karel Moons; Arno Hoes; Theo Verheij |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The British journal of general practice : the journal of the Royal College of General Practitioners Volume: 61 ISSN: 1478-5242 ISO Abbreviation: Br J Gen Pract Publication Date: 2011 Oct |
Date Detail:
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Created Date: 2011-12-13 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9005323 Medline TA: Br J Gen Pract Country: England |
Other Details:
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Languages: eng Pagination: 674-9 Citation Subset: IM |
Affiliation:
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department of general practice, University Medical Center Utrecht, the Netherlands. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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