Primary care physicians' ability to diagnose the most prevalent respiratory diseases

There are few reports on the ability of primary care physicians (PCPs) to diagnose acute and chronic respiratory diseases. We assessed the agreement between PCPs and pulmonologists in diagnosing pulmonary tuberculosis (TB), chronic obstructive pulmonary disease (COPD), asthma and acute respiratory i...

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Published in:The international journal of tuberculosis and lung disease Vol. 20; no. 10; pp. 1392 - 1398
Main Authors: de São José, B P, Camargos, P A M, Bateman, E D, Botelho, C M A, de Seixas Maciel, J G F, Mancuzo, E V, de Amorim Corrêa, R
Format: Journal Article
Language:English
Published: France 01.10.2016
Subjects:
Adult
Asthma - diagnosis
Brazil
Clinical Competence
Cross-Sectional Studies
Female
Humans
Male
Middle Aged
Physicians, Primary Care
Prevalence
Pulmonary Disease, Chronic Obstructive - diagnosis
Respiration Disorders - diagnosis
Surveys and Questionnaires
Tuberculosis, Pulmonary - diagnosis
ISSN:1815-7920
Online Access:Get more information
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Summary:There are few reports on the ability of primary care physicians (PCPs) to diagnose acute and chronic respiratory diseases. We assessed the agreement between PCPs and pulmonologists in diagnosing pulmonary tuberculosis (TB), chronic obstructive pulmonary disease (COPD), asthma and acute respiratory infections (ARI). Metropolitan Region of Belo Horizonte, State of Minas Gerais, Brazil. PCPs filled out a symptom-based questionnaire for adult patients presenting with respiratory symptoms. Their diagnoses were compared to those of three pulmonologists who reviewed the data independently without seeing the patients. Agreement between PCP decisions and those of the pulmonologists was assessed. Among a total of 554 patients, 60 PCPs correctly diagnosed 42.4% as having ARI, 17.3% asthma, 15.7% COPD and 12.4% suspected TB. Agreement between the PCPs and the pulmonologists was as follows: 0.53 for asthma (95%CI 0.45-0.60), 0.53 (95%CI 0.46-0.60) for ARI, 0.45 (95%CI 0.34-0.57) for TB and 0.40 (95%CI 0.29-0.50) for COPD. Only reasonable to moderate agreement was found between PCPs and pulmonologists in diagnosing the most prevalent respiratory conditions. This result emphasises the need to adopt measures and provide tools to improve the diagnostic skills of PCPs for patients presenting with respiratory symptoms.
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ISSN:1815-7920
DOI:10.5588/ijtld.16.0294