AIM: To determine the intra- and inter-observer reliability of respiratory specialists' diagnostic assessments of spirometry and written medical history data obtained from primary care. METHOD: Five respiratory specialists assessed spirometry data and the history of 156 patients randomly selected from referrals to an asthma/COPD-service. The inter-observer reliability was evaluated. After six months, all specialists repeated the assessments and the intraobserver reliability was evaluated. RESULTS: The diagnostic assessments for all patients had reasonable intra- and inter-observer reliability, resulting in a Cohen's kappa (kappa) of 0.67 and 0.66 respectively. The intra-observer reliability for assessing the need for additional diagnostic examinations had an average kappa 0.56 for new patients and an average kappa 0.39 for follow-up examinations. The assessments of clinical stability in follow-up patients--on which therapeutic advice was based--were inconsistent. CONCLUSION: GPs who are reluctant to perform or interpret spirometry themselves may be supported diagnostically by respiratory specialists in an asthma/COPD-service. The reliability of this advice varies. More appropriate criteria for assessing clinical stability in patients with asthma and COPD are necessary to improve the reliability of the therapeutic advice.
AIM: To determine the intra- and inter-observer reliability of respiratory specialists' diagnostic assessments of spirometry and written medical history data obtained from primary care. METHOD: Five respiratory specialists assessed spirometry data and the history of 156 patients randomly selected from referrals to an asthma/COPD-service. The inter-observer reliability was evaluated. After six months, all specialists repeated the assessments and the intraobserver reliability was evaluated. RESULTS: The diagnostic assessments for all patients had reasonable intra- and inter-observer reliability, resulting in a Cohen's kappa (kappa) of 0.67 and 0.66 respectively. The intra-observer reliability for assessing the need for additional diagnostic examinations had an average kappa 0.56 for new patients and an average kappa 0.39 for follow-up examinations. The assessments of clinical stability in follow-up patients--on which therapeutic advice was based--were inconsistent. CONCLUSION: GPs who are reluctant to perform or interpret spirometry themselves may be supported diagnostically by respiratory specialists in an asthma/COPD-service. The reliability of this advice varies. More appropriate criteria for assessing clinical stability in patients with asthma and COPD are necessary to improve the reliability of the therapeutic advice.
Authors: Lucas E M Annelies; Derckx W C C Emmy; Meulepas A Marianne; Smeele J M Ivo; Smeenk W J M Frank; van Schayck P Onno Journal: BMC Res Notes Date: 2012-07-23
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Authors: Anna Jetske Baron; Bertine M J Flokstra-de Blok; Ellen van Heijst; Roland A Riemersma; Agnes M M Sonnenschein-van der Voort; Esther I Metting; Janwillem W H Kocks Journal: Int J Chron Obstruct Pulmon Dis Date: 2020-07-06
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