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  • Title: Difficulties in the interpretation of lung function tests in the diagnosis of asthma and chronic obstructive pulmonary disease.
    Author: Raghunath AS, Innes A, Norfolk L, Hannant M, Greene T, Greenstone M, Morice AH.
    Journal: J Asthma; 2006 Nov; 43(9):657-60. PubMed ID: 17092845.
    Abstract:
    OBJECTIVE: To ascertain differences in the interpretation of spirometry and peak flow measurement between primary care (several practioners and nurses) and specialists in patients with a pre-existing diagnosis of asthma and chronic obstructive pulmonary disease (COPD). DESIGN: A randomized, prospective cohort study of 98 patients with a pre-existing diagnosis of asthma or COPD. Two chest specialists independently interpreted the peak flow and spirometric data and they were also blinded to the primary care results. RESULTS: There was total agreement in interpretation of the data between general practitioners and specialists in only 20 (20.4%). Levels of diagnostic agreement were highest between the two chest specialists (55%) and lowest between the general practice records and the diagnosis assigned by general practitioners (16%). Disagreement between general practitioners and the two chest specialists was consistent (38%) indicating systematic differences in interpretation. CONCLUSIONS: This study raises concerns about differences in the interpretation of spirometry and peak expiratory flow rates in general and hospital practice and the guidelines on which these interpretations are based.
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