title: Effects of one-hour training course and spirometry on the ability of physicians to diagnose and treat chronic obstructive pulmonary disease.
abstract: BACKGROUND
  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.
authors.affiliation: Department of Respiratory Medicine, The 2nd Xiangya Hospital, Central South University, Changsha, Hunan, 410011, P.R. China.
authors.forename: Shan
authors.initials: S
authors.lastname: Cai
authors.affiliation: Department of Internal Medicine, Yale University, New Haven, CT, 06520-8234, United States of America.
authors.forename: Li
authors.initials: L
authors.lastname: Qin
authors.affiliation: Department of Internal Medicine, Yale University, New Haven, CT, 06520-8234, United States of America.
authors.forename: Lynn
authors.initials: L
authors.lastname: Tanoue
authors.affiliation: Department of Respiratory Medicine, The 2nd Xiangya Hospital, Central South University, Changsha, Hunan, 410011, P.R. China.
authors.forename: Anmei
authors.initials: A
authors.lastname: Hu
authors.affiliation: Department of Respiratory Medicine, The 2nd Xiangya Hospital, Central South University, Changsha, Hunan, 410011, P.R. China.
authors.forename: Xiujie
authors.initials: X
authors.lastname: Jia
authors.affiliation: Department of Respiratory Medicine, The 2nd Xiangya Hospital, Central South University, Changsha, Hunan, 410011, P.R. China.
authors.forename: Hong
authors.initials: H
authors.lastname: Luo
authors.affiliation: Department of Respiratory Medicine, The 2nd Xiangya Hospital, Central South University, Changsha, Hunan, 410011, P.R. China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Department of Respiratory Medicine, The 2nd Xiangya Hospital, Central South University, Changsha, Hunan, 410011, P.R. China.
authors.forename: Ping
authors.initials: P
authors.lastname: Chen
authors.affiliation: Department of Respiratory Medicine, The 2nd Xiangya Hospital, Central South University, Changsha, Hunan, 410011, P.R. China.
authors.forename: Hong
authors.initials: H
authors.lastname: Peng
mesh_terms: D000328:Adult; D002983:Clinical Competence; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010821:Physicians, Family / Q000193:education*; D011320:Primary Health Care / Q000592:standards*; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy*; D012720:Severity of Illness Index; D013147:Spirometry; D011795:Surveys and Questionnaires