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Clinical InvestigationsCOPDOffice Spirometry Significantly Improves Early Detection of COPD in General Practice: The DIDASCO Study
Section snippets
General Design of the Study
The target population for early detection of COPD was defined as the age group from 35 to 70 years. The participating GPs were asked to screen every patient in this age group attending clinic at least once during 12 successive weeks for use of bronchodilators and/or inhaled steroids, since they were assumed to have known asthma or COPD. All other subjects were to complete a short questionnaire pointing to signs and symptoms of OLD (Table 1). Patients with at least one positive answer were given
Demographic Data
During a period of 12 weeks from April to July 1999, 22 GPs applied the case-finding algorithm to all of their visiting patients (n = 3,408) aged 35 to 70 years. Two hundred fifty patients (7.3%) used bronchodilators and/or inhaled steroids, and were assumed to have asthma or COPD. The other 3,158 subjects were submitted to the short questionnaire. Seven hundred twenty-eight responders (23%) gave at least one positive answer, indicating that they had a higher probability of OLD. From this
Discussion
The present study demonstrates that spirometry in general practice is feasible and sufficiently accurate. In the target population aged 35 to 70 years, we found 7.4% of patients with formerly unknown OLD. Of these patients, 42% would not have been found without the screening with spirometry. The degree of airflow obstruction was mild to moderate.
Conclusion
The present study shows that spirometry in general practice is feasible provided that the GPs are instructed and trained in the use of a hand-held spirometer. The accuracy of their measurements was found to be highly acceptable. The GPs were able to incorporate spirometry in their daily routines.
If early detection of OLD is to be realized in general practice, the use of a spirometer is essential. Detection based on the use of a questionnaire appeared to be insufficient.
These conclusions could
ACKNOWLEDGMENT
We thank the GPs who participated in the registration: P. Bastaerts, M. Biervliet, P. Boeykens, B. Bruynbroeck, L. De Moor, P. De Ridder, A.M. Deleenheer, L. Frisch, R. Gors, M. Joossens, H. Marechal, L. Martens, C. Micholt, G. Opsomer, W. Renier, A. Roex, M. Roex, I. Tambuyzer, P. Tarpataki, D. Van Achter, D. Van de Sijpe, and L. Van Parijs. We are very grateful to P. Vermeire, C. Van Weel, and C. P. Van Schayck for reviewing the study design.
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Financial support was provided by Boehringer Ingelheim Belgium.