title: Development of an integral assessment approach of health status in patients with obstructive airway diseases: the CORONA study.
abstract: BACKGROUND
  Traditional assessment of patients with obstructive lung diseases (asthma and chronic obstructive pulmonary disease; COPD) relies on physiological tests. The COPD and Asthma Rotterdam Integrated Care Approach (CORONA) study aims to develop a diagnostic pathway with a more comprehensive approach to the assessment of patients with asthma and COPD in secondary care.
  
  
  METHODS
  An eight-step method was used to develop and implement the pathway for patients with asthma or COPD referred to an outpatient hospital setting.
  
  
  RESULTS
  The diagnostic pathway consists of an evidence-based set of measurements prioritized by a Delphi procedure. The pathway incorporates three innovative diagnostics: the metronome-paced hyperventilation test to measure dynamic hyperinflation, an activity monitor to objectively evaluate physical activity in daily life, and the Nijmegen Clinical Screening Instrument as a comprehensive assessment tool to acquire detailed insight into symptoms, functional limitations, and quality of life.
  
  
  CONCLUSIONS
  An innovative diagnostic pathway was developed and implemented for patients with obstructive lung diseases referred to secondary care. As this pathway aims to provide a comprehensive analysis of health status, it focuses on biomedical aspects and also reviews behavioral aspects that further elucidate the patient's health status. The added value of the diagnostic pathway needs to be determined from both an organizational perspective and from the individual patient's viewpoint.
authors.affiliation: Department of Pulmonary Diseases, STZ Center of Excellence for Asthma & COPD, Sint Franciscus Gasthuis, Rotterdam, the Netherlands.
authors.forename: Edmée F M M
authors.initials: EF
authors.lastname: van den Akker
authors.affiliation: Department of Pulmonary Disease, Radboud University Medical Center, Nijmegen, the Netherlands.
authors.forename: Alex J
authors.initials: AJ
authors.lastname: van 't Hul
authors.affiliation: Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, the Netherlands.
authors.forename: Niels H
authors.initials: NH
authors.lastname: Chavannes
authors.affiliation: Department of Pulmonary Diseases, STZ Center of Excellence for Asthma & COPD, Sint Franciscus Gasthuis, Rotterdam, the Netherlands.
authors.forename: Gert-Jan
authors.initials: GJ
authors.lastname: Braunstahl
authors.affiliation: Department of Pulmonary Diseases, STZ Center of Excellence for Asthma & COPD, Sint Franciscus Gasthuis, Rotterdam, the Netherlands.
authors.forename: Alie
authors.initials: A
authors.lastname: van Bruggen
authors.affiliation: Department of Health Care Policy and Management, Institute of Medical Technology Assessment, Erasmus University Rotterdam, Rotterdam, the Netherlands.
authors.forename: Maureen P M H
authors.initials: MP
authors.lastname: Rutten-van Mölken
authors.affiliation: Department of Pulmonary Diseases, STZ Center of Excellence for Asthma & COPD, Sint Franciscus Gasthuis, Rotterdam, the Netherlands.
authors.forename: Johannes C C M
authors.initials: JC
authors.lastname: In 't Veen
mesh_terms: D056044:Actigraphy / Q000295:instrumentation; D000203:Activities of Daily Living; D001249:Asthma / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology / Q000628:therapy; D000066491:Clinical Decision-Making; D017281:Cost of Illness; D019091:Critical Pathways; D019033:Delivery of Health Care, Integrated; D003697:Delphi Technique; D006304:Health Status; D006305:Health Status Indicators; D006801:Humans; D008168:Lung / Q000503:physiopathology*; D009043:Motor Activity; D010358:Patient Participation; D011237:Predictive Value of Tests; D011379:Prognosis; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology / Q000628:therapy; D011788:Quality of Life; D012129:Respiratory Function Tests; D063127:Secondary Health Care; D011795:Surveys and Questionnaires; D013997:Time Factors
keywords: comprehensive assessment; diagnostic pathway; health status; integrated care; shared decision-making