title: [Early detection of COPD in primary care: which tools?].
abstract: BACKGROUND
  The early diagnosis of COPD in general practice is not satisfactory.
  
  
  OBJECTIVE
  To evaluate the impact of different diagnostic tools (Piko-6, Software) in general practice (GP).
  
  
  METHODS
  A multicentre, randomised, controlled study in GP assessing the effect of the tested strategies on the rate of referrals for spirometry and the rate of detection of airflow obstruction.
  
  
  RESULTS
  One thousand one hundred and three patients (55 years old, 60% males, 31 years of smoking habits) were included by 248 GP. The rates of referal to a pneumologist were significantly higher in the Software (50% of patients), and Piko/Software (47%) groups than in the Control (22%) and Piko groups (28%). A high proportion (44%) of lung function tests recommended by the GP were not performed, often because of patient refusal. The confirmation rates were lower in the Software and Piko/Software groups (47% and 43%, respectively) compared with the Piko and Control groups (68% and 79%, respectively). Concordance between PFT and Piko-6 for the diagnosis of airflow obstruction was poor (about 50%).
  
  
  CONCLUSIONS
  The use of software in association or not with the Piko-6 was useful for GPs to identify patients to refer for further lung function testing, but did not improve the confirmation of the obstructive syndrome, mainly due to reluctance of patients to go on to have further lung function tests. The use of a diagnostic tool (software and/or mini-spirometry) does however seem to improve early COPD detection.
authors.affiliation: Département des Maladies Respiratoires, Hôpital de la Croix-Rousse, 69004 Lyon, France.
authors.forename: J-C
authors.initials: JC
authors.lastname: Guerin
authors.forename: N
authors.initials: N
authors.lastname: Roche
authors.forename: E
authors.initials: E
authors.lastname: Vicaut
authors.forename: D
authors.initials: D
authors.lastname: Piperno
authors.forename: G
authors.initials: G
authors.lastname: Granet
authors.forename: M
authors.initials: M
authors.lastname: Jannin
authors.forename: F
authors.initials: F
authors.lastname: Deschamps
authors.forename: P
authors.initials: P
authors.lastname: Godard
mesh_terms: D003937:Diagnosis, Differential; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D008168:Lung / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis* / Q000503:physiopathology; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012984:Software; D013147:Spirometry; D011795:Surveys and Questionnaires