INTRODUCTION: Spirometry may reveal pre-clinical abnormal airway function in asymptomatic subjects and allow a better definition of severity in clinically diagnosed asthma and COPD. The hypothesis of this study was that telespirometry might increase the diagnostic accuracy of asthma and COPD. METHODS: In the Italian "Alliance" study, 638 general practitioners (GPs) were trained to perform telespirometry and were asked to enroll the following categories of subjects: (a) current or ex-smokers without respiratory symptoms; (b) subjects with respiratory symptoms but without a pre-existing diagnosis of asthma or COPD; (c) subjects with a pre-existing clinical diagnosis of asthma; and (d) subjects with a pre-existing clinical diagnosis of COPD. Subjects completed a case report form (CRF) and performed telespirometry in the GP's office. Traces were sent by telephone to a Telespirometry Central Office, where they were interpreted by a pulmonary specialist, according to appropriately defined criteria. The results were returned in real time to the GP. RESULTS: Overall, 9312 subjects were recruited and 7262 (78%) performed an acceptable telespirometric examination and the CRF. In the asymptomatic group, 340/1437 (24%) of the telespirometries were abnormal (147 with moderate-to-severe airway obstruction, i.e. FEV(1) <80% of predicted). Among symptomatic subjects, 1433/3725 (38%) had abnormal telespirometries (682 with moderate-to-severe obstruction). Of the asthmatic subjects, 336/1285 (26%) had moderate-to-severe airway obstruction, while telespirometry was normal in 184/815 (23%) of the COPD group. CONCLUSION: Telespirometry, performed in a GP's office, can aid the diagnosis of obstructive airway diseases and could help GPs to better manage airway obstruction.
INTRODUCTION: Spirometry may reveal pre-clinical abnormal airway function in asymptomatic subjects and allow a better definition of severity in clinically diagnosed asthma and COPD. The hypothesis of this study was that telespirometry might increase the diagnostic accuracy of asthma and COPD. METHODS: In the Italian "Alliance" study, 638 general practitioners (GPs) were trained to perform telespirometry and were asked to enroll the following categories of subjects: (a) current or ex-smokers without respiratory symptoms; (b) subjects with respiratory symptoms but without a pre-existing diagnosis of asthma or COPD; (c) subjects with a pre-existing clinical diagnosis of asthma; and (d) subjects with a pre-existing clinical diagnosis of COPD. Subjects completed a case report form (CRF) and performed telespirometry in the GP's office. Traces were sent by telephone to a Telespirometry Central Office, where they were interpreted by a pulmonary specialist, according to appropriately defined criteria. The results were returned in real time to the GP. RESULTS: Overall, 9312 subjects were recruited and 7262 (78%) performed an acceptable telespirometric examination and the CRF. In the asymptomatic group, 340/1437 (24%) of the telespirometries were abnormal (147 with moderate-to-severe airway obstruction, i.e. FEV(1) <80% of predicted). Among symptomatic subjects, 1433/3725 (38%) had abnormal telespirometries (682 with moderate-to-severe obstruction). Of the asthmatic subjects, 336/1285 (26%) had moderate-to-severe airway obstruction, while telespirometry was normal in 184/815 (23%) of the COPD group. CONCLUSION: Telespirometry, performed in a GP's office, can aid the diagnosis of obstructive airway diseases and could help GPs to better manage airway obstruction.
Authors: Rashid L Bashshur; Gary W Shannon; Brian R Smith; Dale C Alverson; Nina Antoniotti; William G Barsan; Noura Bashshur; Edward M Brown; Molly J Coye; Charles R Doarn; Stewart Ferguson; Jim Grigsby; Elizabeth A Krupinski; Joseph C Kvedar; Jonathan Linkous; Ronald C Merrell; Thomas Nesbitt; Ronald Poropatich; Karen S Rheuban; Jay H Sanders; Andrew R Watson; Ronald S Weinstein; Peter Yellowlees Journal: Telemed J E Health Date: 2014-06-26 Impact factor: 3.536
Authors: Vicente Gil-Guillén; Domingo Orozco-Beltrán; Concepcion V Carratala Munuera; Carlos Plaza-Sirvent; Patricia Lorca-Amorrich; Adriana López-Pineda; María P Vela-Troncoso; Juan J Soler; Manuel Yarza-Cañellas; Antonio Fernández; Luis Rosado-Bretón; Carmen Olivares-Bautista; Alejandro Muñoz-Fernández Journal: BMC Public Health Date: 2011-05-31 Impact factor: 3.295