ArticleThe British journal of general practice : the journal of the Royal College of General Practitioners2011
Does a decision aid help physicians to detect chronic obstructive pulmonary disease?
Article in The British journal of general practice : the journal of the Royal College of General Practitioners, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it, 7 citations in OpenAlex.
- A systematic review of studies comparing diagnostic clinical prediction rules with clinical judgment.PloS one · 2015Pooled it
- Use of serum C reactive protein and procalcitonin concentrations in addition to symptoms and signs to predict pneumonia in patients presenting to primary care with acute cough: diagnostic study.BMJ (Clinical research ed.) · 2013Trial
- Health system characteristics and evidence-based asthma care.Frontiers in allergy · 2025Article
- Methodological standards for the development and evaluation of clinical prediction rules: a review of the literature.Diagnostic and prognostic research · 2019Review
- Article
- Laryngeal measurements and diagnostic tools for diagnosis of chronic obstructive pulmonary disease.Annals of family medicineArticle
Corrections and comments
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundNumerous decision aids have been developed recently, but the value they add above that of the initial clinical assessment is not well known.
aimTo quantify whether a formal decision aid for chronic obstructive pulmonary disease (COPD) adds diagnostic information, above the physician's clinical assessment. DESIGN AND
settingSubanalysis of a diagnostic study in Dutch primary care.
methodSixty-five primary care physicians included 357 patients who attended for persistent cough and were not known to have COPD. The physicians estimated the probability of COPD after short history taking and physical examination. After this, the presence or absence of COPD was determined using results of extensive diagnostic work-up. The extent to which an 8-item decision aid for COPD, which included only symptoms and signs, added diagnostic value above the physician's estimation was quantified by the increase of the area under the receiver operating characteristic curve (ROC area), and the improvement in diagnostic risk classification across two classes: 'low probability of COPD' (<20%) and 'possible COPD' (≥20%).
resultsOne hundred and four patients (29%) had COPD. Adding the decision aid to the clinical assessment increased the ROC area from 0.75 (95% confidence interval [CI] = 0.70 to 0.81) to 0.84 (95% CI = 0.80 to 0.89) (P<0.005), and improved the diagnostic risk classification of the patients, such that 35 fewer patients needed spirometry testing and eight fewer COPD cases were missed.
conclusionA short decision aid for COPD added diagnostic value to the physician's clinical assessment.
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