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GPs split over COPD quality dilemma

GP respiratory experts are divided over whether the Department of Health should make an 11th-hour change to the quality pay indicator for COPD diagnosis to bring it into line with NICE guidance.

A department spokesman said the option was still 'on the agenda for discussion'.

The framework offers five points for confirming a diagnosis with spirometry and reversibility testing. But the NICE guidance concludes that COPD and asthma can be distinguished from history and examination and reversibility testing can be 'misleading'.

Dr David Bellamy, a member of the NICE guidance team and a GP in Bourne-mouth, said it was the result of a two-year process by a multi-disciplinary team, whereas the quality framework was drawn up 'by one man pulling together the available evidence'.

Dr Tony Crockett, a member of the General Practice Airways Group committee and a Swindon GP, threw his weight behind the 'the exemplary rigour of the NICE guidelines'.

But Ayreshire GP Dr John Haughney, chair of the same group and a member of the team updating the BTS/ SIGN national asthma guidelines, said: 'I can't agree on this. I'm not sure I have the skills to differentiate COPD from asthma without reversibility testing.'

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