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GP spirometry tests 'unacceptable'

By Lilian Anekwe

GPs are frequently conducting ‘unsatisfactory' spirometric tests and are not as competent at interpreting test results as secondary care specialists.

A damning analysis published in the September issue of the British Journal of General Practice found more than 15% of test reports performed by GPs were incomplete, and 52% of tests were ‘unacceptable'.

Researchers analysed 212 tests taken over three months by staff in six practices in south London. They measured the ‘usefulness' of the reports by comparing how far the GPs' interpretation of the test results agreed with those made by local secondary care respiratory specialists with respect to the quality of the test, the diagnosis and severity of the disease.

Agreement between primary and secondary care clinicians was only slight with respect to test quality, with clinically significant disagreements caused by incorrect technique identified in 32% of tests.

Agreement with regard to diagnosis was fair, with 29% of interpretations differing between primary and secondary care clinicians, and moderate with respect to severity (32% of disagreements).

GPs were also criticised for unfamiliarity with technology and computer software, including the inability to attaching documents to an email when sending test reports to the researchers.

Dr Patrick White, a senior lecturer in general practice and primary care at King's College London, said the results ‘pointed to an unacceptable quality in the provision of spirometry within primary care for patients with COPD'.

He added: ‘It is not justifiable to invite a patients for a test which may have a 50:50 chance of being conducted inadequately.'

Dr Dermot Ryan, a GP in Loughborough and member of the General Practice Airways Group said it was unsurprising that specialist were better at spirometry than GPs, and added: ‘Rather than damning GPs we should acknowledge that there are GPs who are able to do spirometry as well as specialists, and work to resolve the education and training issues to provide a more uniform standard of ability.'

More than half of GP spirometry tests were considered 'unacceptable' More than half of GP spirometry tests were considered 'unacceptable'

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