Overview

This trial is active, not recruiting.

Conditions pulmonary disease, chronic obstructive, asthma, cough, dyspnea
Treatment expert support for interpretation of spirometry
Sponsor Radboud University
Collaborator ZonMw: The Netherlands Organisation for Health Research and Development
Start date January 2003
End date August 2006
Trial size 39 participants
Trial identifier NCT00131157, 95500, NAF-3.4.02.18, ZonMW 920-03-265

Summary

More and more general practitioners (GPs) use spirometry in their practices. At this time, there is sufficient reason to presume that, after a single postgraduate training program without any further support, most GPs have insufficient knowledge and ability to assure valid interpretation of their spirometry tests. Therefore, some kind of continuous diagnostic support with regard to spirometry interpretation by GPs is advisable. The aim of the present study is to assess whether implementation of spirometry expert support (either by a computerised expert system or a working agreement between general practitioners and respiratory consultants with respect to spirometry interpretation) causes changes in diagnosing and appropriateness and efficiency of medical care in subjects with chronic respiratory morbidity managed in general practice.

United States No locations recruiting
Other Countries No locations recruiting

Study Design

Allocation randomized
Endpoint classification efficacy study
Intervention model parallel assignment
Masking single blind
Primary purpose diagnostic

Primary Outcomes

Measure
Study I: between-group difference in the proportion of cases in which the GP opts for the gold standard diagnosis before versus expert/sham information
time frame:
Study II: between-group difference in the proportion of patients with a changed respiratory diagnosis after spirometry interpretation in a random sample (n=20 patients) taken from an index population per practice
time frame:

Secondary Outcomes

Measure
Study I: between-group difference in the proportion of cases in which the GP opts for the gold standard treatment (prescription, referrals) before versus after the addition of expert/sham information
time frame:
Study II: between-group difference in the proportion of ordered additional investigations and referrals by GPs
time frame:

Eligibility Criteria

Male or female participants at least 18 years old.

Inclusion Criteria: - GP practices with a Windows supported electronic Patient Journal System (PJS) in a certain postal region in the Netherlands. Exclusion Criteria: - GP practices without a Windows supported PJS - Practices outside a certain postcode region

Additional Information

Official title A Randomized-Controlled Evaluation of Spirometry Expert Support in General Practice
Principal investigator Chris van Weel, Prof
Description More and more general practitioners (GPs) use spirometry in their practices. At this time, there is sufficient reason to presume that, after a single postgraduate training program without any further support, most GPs have insufficient knowledge and ability to assure valid interpretation of their spirometry tests. Therefore, some kind of continuous diagnostic support with regard to spirometry interpretation by GPs is advisable. The problem formulation for the study proposed is: "Does implementation of spirometry expert support (either by a computerized expert system or a local working agreement between GPs and respiratory consultants with respect to spirometry interpretation) cause changes in diagnosing and quality and efficiency of medical care in subjects with chronic respiratory morbidity managed in general practice?”. In order to address this issue, two separate studies with different designs are proposed. Study I (n=62 GPs) is an ‘in-depth’ study of the GPs‘ decision-making process with regard to spirometry, and the impact of a computerized expert system on this process. Study II (n=39 general practices) is a pragmatic randomised-controlled implementation study evaluating two realistic modes of spirometry expert support (i.e., a computerized expert system or a working agreement between GPs and respiratory consultants).
Trial information was received from ClinicalTrials.gov and was last updated in February 2007.
Information provided to ClinicalTrials.gov by Radboud University.