REMOTE ELECTRONIC REPORTING OF PRIMARY CARE SPIROMETRY

Patrick White, *King's College London School of Medicine, Department of General Practice and Primary Care, 5 Lambeth Walk, London SE1 6SP. 02078484188, patrick.white@kcl.ac.uk

Wun Wong*

Tracey Fleming, †King's College Hospital NHS Trust, Denmark Hill London SE5 9RS

Barry Gray†

David Armstrong *

Introduction:
Spirometry can be performed in GPs' surgeries but test quality and interpretation are uncertain. We tested feasibility and usefulness of specialist on-line reporting of primary care spirometry. 

Method:
Six randomly selected practices (6000+) were provided with spirometer, training, and workload reimbursement. Results were given to a practice clinician and the local respiratory unit for interpretation. Written reports from both were compared to assess interpretation of quality, and diagnosis.

Results:
276 eligible tests. Mean age 64 years (19-94 yrs), mean % predicted FEV1 69% (16-127%). 54 of 181 (30%) tests acceptable in primary care were un-acceptable to the specialists. 109 of 124 (88%) tests judged obstructive by the specialists were judged obstructive in primary care. 42 of 60 (67%) tests judged moderate or severe by the specialists were judged moderate or severe in primary care. There were clinically significant disagreements in interpretation of the acceptability of 54 (25%) tests, of diagnosis of obstruction in 46 tests (21%), and of severity in 18 tests (8%).

Conclusion:
On-line reporting of primary care spirometry is feasible. Disagreement between primary care and specialist interpretation tests suggests that specialist reporting of tests is essential to ensure primary care spirometry is carried out to an acceptable standard.

Back to Abstracts Menu