Nigel Stocks1, Tom Fahey. 1. Department of General Practice, University of Adelaide, Adelaide 5005, Australia. nigel.stocks@adelaide.edu.au
Abstract
BACKGROUND: It is unclear which symptoms and signs GPs use when attributing diagnostic labels to patients with acute respiratory illness (ARI). OBJECTIVE: We sought to ascertain GPs' self-reported definitions of ARI. METHODS: A postal questionnaire concerned with the diagnosis of ARI was sent to all registered GPs in Avon Health Authority. GPs were asked to choose a clinical term that would describe the clinical presentation in four hypothetical patients, and the next three questions asked them to define acute bronchitis, upper respiratory tract infection (URTI) and any other term they used for ARI (excluding pneumonia). We measured proportions and compared responses across the three diagnostic categories. RESULTS: The majority (88%) of GPs agreed that cough associated with fever should be labelled as a URTI. When sputum and chest signs were also present, opinion was more divided, with 62% diagnosing acute bronchitis in young patients and 72% lower respiratory tract infection in old patients. CONCLUSIONS: This study demonstrates that there is more consistent use of diagnostic labels for URTI than for acute bronchitis or other terms used to label ARI. In the future, researchers should quantify the prognostic significance of symptoms and signs in ARI and provide GPs with a more rational approach to the diagnosis and management of ARI.
BACKGROUND: It is unclear which symptoms and signs GPs use when attributing diagnostic labels to patients with acute respiratory illness (ARI). OBJECTIVE: We sought to ascertain GPs' self-reported definitions of ARI. METHODS: A postal questionnaire concerned with the diagnosis of ARI was sent to all registered GPs in Avon Health Authority. GPs were asked to choose a clinical term that would describe the clinical presentation in four hypothetical patients, and the next three questions asked them to define acute bronchitis, upper respiratory tract infection (URTI) and any other term they used for ARI (excluding pneumonia). We measured proportions and compared responses across the three diagnostic categories. RESULTS: The majority (88%) of GPs agreed that cough associated with fever should be labelled as a URTI. When sputum and chest signs were also present, opinion was more divided, with 62% diagnosing acute bronchitis in young patients and 72% lower respiratory tract infection in old patients. CONCLUSIONS: This study demonstrates that there is more consistent use of diagnostic labels for URTI than for acute bronchitis or other terms used to label ARI. In the future, researchers should quantify the prognostic significance of symptoms and signs in ARI and provide GPs with a more rational approach to the diagnosis and management of ARI.
Authors: Jochen W L Cals; Leon de Bock; Pieter-Jan H W Beckers; Nick A Francis; Rogier M Hopstaken; Kerenza Hood; Eefje G P M de Bont; Christopher C Butler; Geert-Jan Dinant Journal: Ann Fam Med Date: 2013 Mar-Apr Impact factor: 5.166
Authors: Martin C Gulliford; A Toby Prevost; Judith Charlton; Dorota Juszczyk; Jamie Soames; Lisa McDermott; Kirin Sultana; Mark Wright; Robin Fox; Alastair D Hay; Paul Little; Michael V Moore; Lucy Yardley; Mark Ashworth Journal: BMJ Date: 2019-02-12
Authors: Martin C Gulliford; Michael V Moore; Paul Little; Alastair D Hay; Robin Fox; A Toby Prevost; Dorota Juszczyk; Judith Charlton; Mark Ashworth Journal: BMJ Date: 2016-07-04
Authors: Alastair D Hay; Niamh M Redmond; Sophie Turnbull; Hannah Christensen; Hannah Thornton; Paul Little; Matthew Thompson; Brendan Delaney; Andrew M Lovering; Peter Muir; John P Leeming; Barry Vipond; Beth Stuart; Tim J Peters; Peter S Blair Journal: Lancet Respir Med Date: 2016-09-01 Impact factor: 30.700