RT Journal Article
SR Electronic
T1 Impact of a spirometry expert system on general practitioners' decision making
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 84
OP 92
DO 10.1183/09031936.00012007
VO 31
IS 1
A1 P. J. P. Poels
A1 T. R. J. Schermer
A1 D. P. A. Schellekens
A1 R. P. Akkermans
A1 P. F. de Vries Robbé
A1 A. Kaplan
A1 B. J. A. M. Bottema
A1 C. van Weel
YR 2008
UL http://erj.ersjournals.com/content/31/1/84.abstract
AB The present study assessed the impact of computerised spirometry interpretation expert support on the diagnostic achievements of general practitioners (GPs), and on GPs' decision making in diagnosing chronic respiratory disease. A cluster-randomised controlled trial was performed in 78 GPs who each completed 10 standardised paper case descriptions. Intervention consisted of support for GPs' spirometry interpretation either by an expert system (expert support group) or by sham information (control group). Agreement of GPs' diagnoses was compared with an expert panel judgement, which served as the primary outcome. Secondary outcomes were: additional diagnostic test rates; width of differential diagnosis; certainty of diagnosis; estimated severity of disease; referral rate; and medication or nonmedication changes. Effects were expressed as odds ratios (ORs) with 95% confidence intervals (CIs). There were no differences between the expert support and control groups in the agreement between GPs and expert panel diagnosis of chronic obstructive pulmonary disease (OR (95% CI) 1.08 (0.70–1.66)), asthma (1.13 (0.70–1.80)), and absence of respiratory disease (1.32 (0.61–2.86)). A higher rate of additional diagnostic tests was observed in the expert support group (2.5 (1.17–5.35)). Computerised spirometry expert support had no detectable benefit on general practitioners' diagnostic achievements and the decision-making process when diagnosing chronic respiratory disease.