The Medical journal of Australia
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Randomized Controlled Trial Multicenter Study Comparative Study
Predictors of accuracy of diagnosis of chronic obstructive pulmonary disease in general practice.
To compare the clinical diagnosis of chronic obstructive pulmonary disease (COPD) with results of post-bronchodilator spirometry in general practice, and examine practitioner, practice and patient characteristics associated with agreement between clinical and spirometric diagnoses. ⋯ A substantial proportion of patients clinically identified as having COPD in general practice do not have the condition according to spirometric criteria, with inaccurate diagnosis more common in patients with comorbidities. Policy and practice change is needed to support the use of spirometry in primary care.
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To evaluate the prescribing practices of Australian dispensing doctors (DDs) and to explore their interpretations of the findings. ⋯ Contrary to overseas findings, we found no evidence that Australian DDs overprescribed because of their additional dispensing role.