TY - JOUR T1 - December Focus JF - British Journal of General Practice JO - Br J Gen Pract SP - 890 LP - 890 DO - 10.3399/bjgp09X473097 VL - 59 IS - 569 AU - David Jewell Y1 - 2009/12/01 UR - http://bjgp.org/content/59/569/890.abstract N2 - There are findings to cheer in this month's BJGP, and others to provide a little critical thought. Lets start with two articles from the Netherlands. On page 927 there is a report that shows rates of both COPD and its exacerbations have decreased over a 25-year period. Interpreting such trends is always tricky and the authors are rightly cautious, but they point out that this parallels the decline in smoking among men, and conclude that it represents a genuine fall in the workload for GPs. Mind, there remains a bit of a problem with the spirometry to diagnose COPD (page 921). This study can be summed up as ‘Better than expected, but still room for improvement.’ Here too, care is required in the interpretation. The study seemed to use stringent standards when deciding what was and was not acceptable, so there is a gap between the numbers … ER -