B P de São José1, P A M Camargos2, E D Bateman3, C M A Botelho4, J G F de Seixas Maciel5, E V Mancuzo6, R de Amorim Corrêa6. 1. Post Graduate Programme on Infectious Diseases and Tropical Medicine, Federal University of Minas Gerais School of Medicine, Belo Horizonte, Minas Gerais, Brazil. 2. Paediatric Pulmonology Unit, University Hospital, Federal University of Minas Gerais School of Medicine, Belo Horizonte, Minas Gerais, Brazil. 3. Division of Pulmonology, Department of Medicine, University of Cape Town and University of Cape Town Lung Institute, Cape Town, South Africa. 4. Pulmonology Department, University Hospital, Federal University of Minas Gerais, Belo Horizonte, Brazil. 5. Pulmonology Department, Santa Casa Hospital, Belo Horizonte, Brazil. 6. Pulmonary Department, Medical School and Pulmonology Unit, University Hospital, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
Abstract
BACKGROUND: 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). SETTING: Metropolitan Region of Belo Horizonte, State of Minas Gerais, Brazil. METHODS: 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. RESULTS: 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. CONCLUSION: 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.
BACKGROUND: 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). SETTING: Metropolitan Region of Belo Horizonte, State of Minas Gerais, Brazil. METHODS: 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. RESULTS: 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. CONCLUSION: 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.
Authors: Bruno Piassi São José; Eric Bateman; Cláudia Myriam Amaral Botelho; José Geraldo Félix de Seixas Maciel; Eliane Viana Mancuzo; Paulo A M Camargos; Ricardo Amorim Corrêa Journal: J Thorac Dis Date: 2022-07 Impact factor: 3.005