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A faulty production line

Q&O points 'may lead to spirometry errors'

By Rob Finch

Quality and outcomes incentives for GPs to carry out spirometry could lead to clinical errors, a leading specialist has warned.

Professor Martyn Partridge, professor of respiratory medicine at Imperial College

London, said he feared quality indicators for chronic obstructive pulmonary disease (COPD) contained in the new GMS contract could turn spirometry into a 'box-ticking exercise'.

In an editorial in Airways, Professor Partridge, a former chair of the British Thoracic Society, referred to the six Q&O points available to GPs assessing severity of COPD using spirometry under the contract.

He foresaw several potential clinical pitfalls in this. Without maximal expiratory effort by the patient, misleading results could have serious consequences.

'If you wrongly diagnose a small lung disorder and give the wrong treatment, that would be a mistake,' he said.

'What we must guard against is poorly performed spirometry undertaken for the wrong reasons. We must reinvent this technique as an essential clinical tool that enhances diagnostic accuracy and aids better classification in people with a variety of lung diseases.'

Professor Partridge stressed that there was no conflict between forthcoming NICE guidelines and the quality framework of the contract.

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