Norwegian Organization for Quality Improvement of Laboratory Examinations, Haraldsplass Deaconess Hospital, Bergen, Norway.
Holter legekontor, 2034, Holter, Norway.
BMC Fam Pract. 2020 Nov 18;21(1):235. doi: 10.1186/s12875-020-01310-x.
General practitioners (GPs) in Norway increasingly use spirometry diagnostically as well as in follow up of patients with respiratory complaints, but little is known about their skills and knowledge in this area. The aim of the present study was to investigate how GPs interpret a case history and spirometry recordings of a patient with chronic obstructive pulmonary disease (COPD), and their knowledge about their own spirometer.
A web-based survey, consisting of a case history and spirometry recordings of a patient with COPD, was distributed to the 4700 members of the Norwegian GP Association. In addition to background information about themselves and their spirometer, topics included whether they requested, and how they interpreted, a spirometry reversibility-test, identification of the of most likely diagnosis, and recognition of the spirometry parameters used to diagnose COPD and grade airway obstruction. Immediate feedback was provided for educational purposes.
Six hundred thirty GPs responded. Twenty six percent would not request a reversibility test, but 81% identified COPD as the most likely diagnosis. Less than 50% correctly identified the spirometry parameters used for diagnosis of COPD and grading the airway obstruction. One in five (21%) did not know which spirometer was used in their own practice, and 49 and 61% did not know which reference values were used for adults and children, respectively. Participants evaluated the survey as useful (average 74 points on a 0-100 scale) and would like more case-based surveys concerning use of spirometry in the future (average 91 points).
In this cohort of self-selected GPs, probably more interested in respiratory medicine than the average GP, we identified several problem areas and gaps in knowledge regarding the use of spirometry.
挪威的全科医生（GP）越来越多地将肺量测定法用于诊断以及对有呼吸系统症状的患者进行随访，但对于他们在这方面的技能和知识却知之甚少。本研究的目的是调查全科医生如何解释一位慢性阻塞性肺疾病（COPD）患者的病史和肺量测定记录，以及他们对自己肺量计的了解。
通过网络向挪威全科医生协会的 4700 名成员分发了一份包含 COPD 患者病史和肺量测定记录的在线调查。除了他们自己和肺量计的背景信息外，调查内容还包括他们是否要求进行肺量测定可逆性试验以及如何解释该试验，是否识别最可能的诊断，以及是否能够识别用于诊断 COPD 和分级气道阻塞的肺量计参数。为了教育目的，立即提供了反馈。
630 名全科医生做出了回应。26%的人不会要求进行可逆性试验，但 81%的人认为 COPD 是最可能的诊断。不到 50%的人能够正确识别用于诊断 COPD 和分级气道阻塞的肺量计参数。五分之一（21%）的人不知道他们自己的实践中使用了哪种肺量计，而 49%和 61%的人分别不知道成人和儿童使用的参考值是多少。参与者认为该调查很有用（0-100 分制的平均得分为 74 分），并希望未来有更多基于病例的关于肺量测定法使用的调查（平均得分为 91 分）。
在这个由自我选择的全科医生组成的队列中，他们可能比一般的全科医生对呼吸医学更感兴趣，我们发现了一些在使用肺量测定法方面的问题和知识差距。
