Quantification of inaccurate diagnosis of COPD in primary care medicine: an analysis of the COACH clinical audit
| Autor: | Abad-Arranz, Maria, Moran-Rodriguez, Ana, Mascaros Balaguer, Enrique, Quintana Velasco, Carmen, Abad Polo, Laura, Nunez Palomo, Sara, Gonzalvez Rey, Jaime, Fernandez Vargas, Ana Maria, Hidalgo Requena, Antonio, Helguera Quevedo, Jose Manuel, Garcia Pardo, Marina, Luis Lopez-Campos, Jose, COACH Study Investigators |
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| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Male
humanos Comorbidity International Journal of Chronic Obstructive Pulmonary Disease Pulmonary Disease Chronic Obstructive Predictive Value of Tests Risk Factors Prevalence factores de riesgo COPD Humans Diagnostic Errors Practice Patterns Physicians' Lung Original Research pruebas de valores predictivos Medical Audit Primary Health Care errores diagnósticos prevalencia clinical audit Smoking Age Factors Reproducibility of Results hábito de fumar Prognosis primary care medicine pronóstico reproducibilidad de resultados pulmón Spain inaccurate diagnosis Female |
| Zdroj: | International Journal of Chronic Obstructive Pulmonary Disease Digital.CSIC. Repositorio Institucional del CSIC instname |
| Popis: | [Background] Inaccurate diagnosis in COPD is a current problem with relevant consequences in terms of inefficient health care, which has not been thoroughly studied in primary care medicine. The aim of the present study was to evaluate the degree of inaccurate diagnosis in Primary Care in Spain and study the determinants associated with it. [Methods] The Community Assessment of COPD Health Care (COACH) study is a national, observational, randomized, non-interventional, national clinical audit aimed at evaluating clinical practice for patients with COPD in primary care medicine in Spain. For the present analysis, a correct diagnosis was evaluated based on previous exposure and airway obstruction with and without the presence of symptoms. The association of patient-level and center-level variables with inaccurate diagnosis was studied using multivariate multilevel binomial logistic regression models. [Results] During the study 4,307 cases from 63 centers were audited. The rate of inaccurate diagnosis was 82.4% (inter-regional range from 76.8% to 90.2%). Patient-related interventions associated with inaccurate diagnosis were related to active smoking, lung function evaluation, and specific therapeutic interventions. Center-level variables related to the availability of certain complementary tests and different aspects of the resources available were also associated with an inaccurate diagnosis. [Conclusions] The prevalence data for the inaccurate diagnosis of COPD in primary care medicine in Spain establishes a point of reference in the clinical management of COPD. The descriptors of the variables associated with this inaccurate diagnosis can be used to identify cases and centers in which inaccurate diagnosis is occurring considerably, thus allowing for improvement. |
| Databáze: | OpenAIRE |
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