Effects of one-hour training course and spirometry on the ability of physicians to diagnose and treat chronic obstructive pulmonary disease

Shan Cai; Li Qin; Lynn Tanoue; Anmei Hu; Xiujie Jia; Hong Luo; Yan Chen; Ping Chen; Hong Peng

doi:10.1371/journal.pone.0117348

Effects of one-hour training course and spirometry on the ability of physicians to diagnose and treat chronic obstructive pulmonary disease

PLoS One. 2015 Feb 23;10(2):e0117348. doi: 10.1371/journal.pone.0117348. eCollection 2015.

Authors

Shan Cai¹, Li Qin², Lynn Tanoue², Anmei Hu¹, Xiujie Jia¹, Hong Luo¹, Yan Chen¹, Ping Chen¹, Hong Peng¹

Affiliations

¹ Department of Respiratory Medicine, The 2nd Xiangya Hospital, Central South University, Changsha, Hunan, 410011, P.R. China.
² Department of Internal Medicine, Yale University, New Haven, CT, 06520-8234, United States of America.

Abstract

Backgrounds: In China, the prevalence of chronic obstructive pulmonary disease (COPD) in persons 40 years of age or older is estimated at 8.2%, but this is likely a substantial underestimate.

Methods: Eight secondary hospitals which didn't have spirometries were chosen randomly in Hunan province of central south China. Physician subjects at these hospitals underwent a one-hour training course on the Chinese COPD guidelines. Physicians answered questionnaires assessing their knowledge of the guidelines before and after the training session. The mean correct scores of questionnaires were compared before and after training. Four out of the eight hospitals were given access to spirometry. Eligible patient subjects underwent spirometry testing prior to the physician visit. After seeing the patient, physicians were asked to answer a questionnaire relating to the diagnosis and severity of COPD. Physicians were then given the results of the spirometry, and asked to answer the same questionnaire. Physicians' responses before and after receiving the spirometry results were compared.

Results: 225 physicians participated in the training session. 207 questionnaires were completed. Mean scores (out of 100) before and after the training were 53.1 ± 21.7 and 93.3 ± 9.8, respectively. 18 physicians and 307 patient subjects participated in the spirometry intervention. Based on spirometric results, the prevalence of COPD was 38.8%. Physicians correctly identified the presence of COPD without spirometric data in 85 cases (76.6%); this increased to 117 cases (97.4%) once spirometric data were available. Without spirometric data, physicians incorrectly diagnosed COPD in 38 patients; this decreased to 6 patients once spirometric data were available. Spirometric data also improved the ability of physicians to correctly grade COPD severity.

Conclusions: Simple educational training can substantially improve physicians' knowledge relating to COPD. Spirometry combined with education improves the ability of physicians to diagnose COPD and to assess its severity.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Clinical Competence*
Female
Humans
Male
Middle Aged
Physicians, Family / education*
Primary Health Care / standards*
Pulmonary Disease, Chronic Obstructive / diagnosis*
Pulmonary Disease, Chronic Obstructive / physiopathology
Pulmonary Disease, Chronic Obstructive / therapy*
Severity of Illness Index
Spirometry*
Surveys and Questionnaires

Grants and funding

This study was supported by the Chia Fellowship of Yale-China Program, Chronic Respiratory Disease Funds of the Chinese Medical Association (07010310039), and National Key Clinical Specialty Construction Projects. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.