[Difficulties in the assessment of dyspnea and respiratory function in general practice].
BACKGROUND
Dyspnea is one of the principal signs of chronic respiratory diseases.


OBJECTIVE
To determine the appropriate questions and tests for recognizing dyspnea, 295 general practitioners questioned 1991 patients with or at risk of COPD in this cross-sectional study. After a brief training session, the physicians were asked to assess respiratory function with a small electronic spirometer.


RESULTS
A questionnaire with a six-point semi-quantitative scale of dyspnea detected more dyspneic patients (78.1%) than the single question "Are you usually short of breath?" (68.6%), which in turn detected this symptom more often than simply listening for spontaneous complaints (33.7%). Even when dyspnea was reported only for substantial exertion, it was associated with impairment of all domains of quality of life. Only half the spirometry results met the minimal criteria of validity and reproducibility.


CONCLUSIONS
These results underline the importance of a specific, systematic assessment of dyspnea in patients at risk, and the need for sufficient training and practice before the use of electronic spirometers in general practice.
Roche
Nicolas
N
Pneumologie et Réanimation, Hôtel-Dieu, Université Paris Descartes, F-75181 Paris 04, France. nicolas.roche@htd.aphp.fr
Perez
Thierry
T
Martinat
Yann
Y
Huas
Dominique
D
Serrier
Philippe
P
Pribil
Céline
C
Chanal
Isabelle
I
Huchon
Gérard
G