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D

iagnostic

accuracy

of

respiratory

diseases

in

primary

health

units

R

ev

A

ssoc

M

ed

B

ras

2014; 60(6):599-612

607

Table 1

 Synopsis of the articles relating to acute respiratory tract infections (ARI), tuberculosis, asthma, COPD, and asthma and COPD in conjunction (continuation)

Asthma and COPD

33

Melbye et al.,

2011,

Norway

To describe symptoms and lung

function in patients diagnosed with

asthma or COPD in primary care

and to describe how the results of

spirometry fit the diagnoses made

by GPs

Spirometry

Cross-

sectional

367; ≥40; 62

Not informed

The diagnosis of COPD was confirmed by

spirometry and according to GOLD

7

criteria in

68.1% of patients, while the diagnosis of asthma

was confirmed in 17.1%. The kappa agreement

between the diagnosis of COPD in the medical

record with the spirometric diagnosis was 0.50.

Spirometry helped confirm that patients had a

mixed disease but did not discriminate between

asthma and COPD in all cases

34

Izquierdo

et al., 2010,

Spain

Goal was to analyze the diagnostic

accuracy in patients receiving

inhaled medications in primary care

Spirometry

Cross-

sectional

9,931; ≥18; 58.3 1,449

4,188 (42.9%) had a diagnosis of asthma, 4,175

(42.8%) had a diagnosis of COPD, and 1,389 had

non-identifiable diagnoses. Among patients aged

over 40 years with diagnoses of COPD and

spirometry (50.9%), only 13.9% met the GOLD

criteria

7

35

Weidinger et

al., 2009,

Sweden

To assess adherence to guidelines in

primary care in patients with asthma

and COPD

Swedish

national

guidelines for

asthma and

COPD

Cross-

sectional

623; All age groups;

not informed

Not informed

Adhesion was found in 130/499 (26%) of patients

with initial diagnosis of asthma and 35/124 (28%)

of patients with initial diagnosis of COPD

36

Raghunath et

al., 2006,

United

Kingdom

To assess differences in the

interpretation of spirometry and

peak expiratory flow (PEF) between

primary care GPs and pulmonary

specialists in patients with a

previous diagnosis of asthma or

COPD

Pulmonologists Cohort

102; ≥45 years; not

informed

Not informed

The concordance between the diagnoses of

generalists and specialists (Kappa) in the

evaluation of tests was 0.20

(continues)