A case scenario study for the assessment of physician’s behavior in the management of COPD: the WHY study

Oguz Kilinc,1 Aylin Konya,2 Metin Akgun,3 Esra Uzaslan,4 Abdullah Sayiner5 1Department of Chest Diseases, Dokuz Eylül University Medical Faculty, Izmir, Turkey; 2Department of Medical Management, Novartis Pharmaceuticals, Istanbul, Turkey; 3Department of Chest Diseases, Atatürk University Medical Faculty, Erzurum, Turkey; 4Department of Chest Diseases, Uludağ University Medical Faculty, Bursa, Turkey; 5Department of Chest Diseases, Ege University Medical Faculty, Izmir, Turkey Purpose: COPD diagnosis is mainly based on clinical judgment of physicians. Physicians do not also refer to COPD guidelines in their daily practice. This study aimed to assess attitudes of physicians regarding COPD diagnosis, treatment, and follow-up and to identify the factors influencing physicians’ decisions in clinical practice. Patients and methods: Fifty physicians were selected from 12 EuroStat NUTS 2 regions and asked to assess seven fictitious case scenarios. The following five scenarios described patients with COPD: Case Global Initiative for Chronic Obstructive Lung Disease (GOLD) A-smoker and Case GOLD A-nonsmoker were previously undiagnosed patients presenting with dyspnea, Case GOLD D-smoker and GOLD B-exsmoker were COPD patients presenting with exacerbation, Case GOLD B-smoker was a previously diagnosed COPD patient with dyspnea in stable phase, Case asthma–COPD overlap syndrome, and Case obesity hypoventilation syndrome. Patients’ history, physical examination findings, pulmonary function tests, and X-ray images were prepared before the study by an experts’ committee and provided to the physicians upon their request, until they reached a final decision. The physicians completed a questionnaire including information about their clinical practices and institutions. Results: According to the GOLD 2015 recommendations, of the physicians, 44% performed guideline-concordant diagnosis in the first five scenarios, who were all COPD patients, and 6% performed guideline-concordant diagnosis in all cases. There was a negative correlation between high workload and making a guideline-concordant diagnosis (P=0.038, rho =-0.417). Even when the physicians made a guideline-concordant diagnosis of COPD, only a minority (10%–22%) used the GOLD classification. Logistic regression analysis revealed that working in a tertiary health care center was a significant factor in favor of establishing a guideline-concordant diagnosis of COPD (P=0.029, OR =6.139 [95% CI: 1.20–31.32]). Conclusion: Management of COPD patients in Turkey does not generally follow the GOLD criteria but is rather based on physicians’ clinical experience. Heavy workload appears to adversely affect the correctness of clinical decisions. Keywords: COPD, practice pattern, real-life scenario, physician decision, GOLD criteria Ausführliche Beschreibung

Gespeichert in:

Autor*in:	Kilinc O [verfasserIn] Konya A [verfasserIn] Akgun M [verfasserIn] Uzaslan E [verfasserIn] Sayiner A [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2018

Schlagwörter:	Chronic obstructive pulmonary disease practice pattern real-life scenario physician decision GOLD criteria

Übergeordnetes Werk:	In: International Journal of COPD - Dove Medical Press, 2009, (2018), Seite 2751-2758
Übergeordnetes Werk:	year:2018 ; pages:2751-2758

Links:	Link aufrufen Link aufrufen Journal toc

Katalog-ID:	DOAJ012565105

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allfields	(DE-627)DOAJ012565105 (DE-599)DOAJ55729487234543418e98833ca0b3e4ce DE-627 ger DE-627 rakwb eng RC705-779 Kilinc O verfasserin aut A case scenario study for the assessment of physician’s behavior in the management of COPD: the WHY study 2018 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Oguz Kilinc,1 Aylin Konya,2 Metin Akgun,3 Esra Uzaslan,4 Abdullah Sayiner5 1Department of Chest Diseases, Dokuz Eylül University Medical Faculty, Izmir, Turkey; 2Department of Medical Management, Novartis Pharmaceuticals, Istanbul, Turkey; 3Department of Chest Diseases, Atatürk University Medical Faculty, Erzurum, Turkey; 4Department of Chest Diseases, Uludağ University Medical Faculty, Bursa, Turkey; 5Department of Chest Diseases, Ege University Medical Faculty, Izmir, Turkey Purpose: COPD diagnosis is mainly based on clinical judgment of physicians. Physicians do not also refer to COPD guidelines in their daily practice. This study aimed to assess attitudes of physicians regarding COPD diagnosis, treatment, and follow-up and to identify the factors influencing physicians’ decisions in clinical practice. Patients and methods: Fifty physicians were selected from 12 EuroStat NUTS 2 regions and asked to assess seven fictitious case scenarios. The following five scenarios described patients with COPD: Case Global Initiative for Chronic Obstructive Lung Disease (GOLD) A-smoker and Case GOLD A-nonsmoker were previously undiagnosed patients presenting with dyspnea, Case GOLD D-smoker and GOLD B-exsmoker were COPD patients presenting with exacerbation, Case GOLD B-smoker was a previously diagnosed COPD patient with dyspnea in stable phase, Case asthma–COPD overlap syndrome, and Case obesity hypoventilation syndrome. Patients’ history, physical examination findings, pulmonary function tests, and X-ray images were prepared before the study by an experts’ committee and provided to the physicians upon their request, until they reached a final decision. The physicians completed a questionnaire including information about their clinical practices and institutions. Results: According to the GOLD 2015 recommendations, of the physicians, 44% performed guideline-concordant diagnosis in the first five scenarios, who were all COPD patients, and 6% performed guideline-concordant diagnosis in all cases. There was a negative correlation between high workload and making a guideline-concordant diagnosis (P=0.038, rho =-0.417). Even when the physicians made a guideline-concordant diagnosis of COPD, only a minority (10%–22%) used the GOLD classification. Logistic regression analysis revealed that working in a tertiary health care center was a significant factor in favor of establishing a guideline-concordant diagnosis of COPD (P=0.029, OR =6.139 [95% CI: 1.20–31.32]). Conclusion: Management of COPD patients in Turkey does not generally follow the GOLD criteria but is rather based on physicians’ clinical experience. Heavy workload appears to adversely affect the correctness of clinical decisions. Keywords: COPD, practice pattern, real-life scenario, physician decision, GOLD criteria Chronic obstructive pulmonary disease practice pattern real-life scenario physician decision GOLD criteria Diseases of the respiratory system Konya A verfasserin aut Akgun M verfasserin aut Uzaslan E verfasserin aut Sayiner A verfasserin aut In International Journal of COPD Dove Medical Press, 2009 (2018), Seite 2751-2758 (DE-627)504104357 (DE-600)2212419-6 11782005 nnns year:2018 pages:2751-2758 https://doaj.org/article/55729487234543418e98833ca0b3e4ce kostenfrei https://www.dovepress.com/a-case-scenario-study-for-the-assessment-of-physicians-behavior-in-the-peer-reviewed-article-COPD kostenfrei https://doaj.org/toc/1178-2005 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 2018 2751-2758
spelling	(DE-627)DOAJ012565105 (DE-599)DOAJ55729487234543418e98833ca0b3e4ce DE-627 ger DE-627 rakwb eng RC705-779 Kilinc O verfasserin aut A case scenario study for the assessment of physician’s behavior in the management of COPD: the WHY study 2018 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Oguz Kilinc,1 Aylin Konya,2 Metin Akgun,3 Esra Uzaslan,4 Abdullah Sayiner5 1Department of Chest Diseases, Dokuz Eylül University Medical Faculty, Izmir, Turkey; 2Department of Medical Management, Novartis Pharmaceuticals, Istanbul, Turkey; 3Department of Chest Diseases, Atatürk University Medical Faculty, Erzurum, Turkey; 4Department of Chest Diseases, Uludağ University Medical Faculty, Bursa, Turkey; 5Department of Chest Diseases, Ege University Medical Faculty, Izmir, Turkey Purpose: COPD diagnosis is mainly based on clinical judgment of physicians. Physicians do not also refer to COPD guidelines in their daily practice. This study aimed to assess attitudes of physicians regarding COPD diagnosis, treatment, and follow-up and to identify the factors influencing physicians’ decisions in clinical practice. Patients and methods: Fifty physicians were selected from 12 EuroStat NUTS 2 regions and asked to assess seven fictitious case scenarios. The following five scenarios described patients with COPD: Case Global Initiative for Chronic Obstructive Lung Disease (GOLD) A-smoker and Case GOLD A-nonsmoker were previously undiagnosed patients presenting with dyspnea, Case GOLD D-smoker and GOLD B-exsmoker were COPD patients presenting with exacerbation, Case GOLD B-smoker was a previously diagnosed COPD patient with dyspnea in stable phase, Case asthma–COPD overlap syndrome, and Case obesity hypoventilation syndrome. Patients’ history, physical examination findings, pulmonary function tests, and X-ray images were prepared before the study by an experts’ committee and provided to the physicians upon their request, until they reached a final decision. The physicians completed a questionnaire including information about their clinical practices and institutions. Results: According to the GOLD 2015 recommendations, of the physicians, 44% performed guideline-concordant diagnosis in the first five scenarios, who were all COPD patients, and 6% performed guideline-concordant diagnosis in all cases. There was a negative correlation between high workload and making a guideline-concordant diagnosis (P=0.038, rho =-0.417). Even when the physicians made a guideline-concordant diagnosis of COPD, only a minority (10%–22%) used the GOLD classification. Logistic regression analysis revealed that working in a tertiary health care center was a significant factor in favor of establishing a guideline-concordant diagnosis of COPD (P=0.029, OR =6.139 [95% CI: 1.20–31.32]). Conclusion: Management of COPD patients in Turkey does not generally follow the GOLD criteria but is rather based on physicians’ clinical experience. Heavy workload appears to adversely affect the correctness of clinical decisions. Keywords: COPD, practice pattern, real-life scenario, physician decision, GOLD criteria Chronic obstructive pulmonary disease practice pattern real-life scenario physician decision GOLD criteria Diseases of the respiratory system Konya A verfasserin aut Akgun M verfasserin aut Uzaslan E verfasserin aut Sayiner A verfasserin aut In International Journal of COPD Dove Medical Press, 2009 (2018), Seite 2751-2758 (DE-627)504104357 (DE-600)2212419-6 11782005 nnns year:2018 pages:2751-2758 https://doaj.org/article/55729487234543418e98833ca0b3e4ce kostenfrei https://www.dovepress.com/a-case-scenario-study-for-the-assessment-of-physicians-behavior-in-the-peer-reviewed-article-COPD kostenfrei https://doaj.org/toc/1178-2005 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 2018 2751-2758
allfields_unstemmed	(DE-627)DOAJ012565105 (DE-599)DOAJ55729487234543418e98833ca0b3e4ce DE-627 ger DE-627 rakwb eng RC705-779 Kilinc O verfasserin aut A case scenario study for the assessment of physician’s behavior in the management of COPD: the WHY study 2018 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Oguz Kilinc,1 Aylin Konya,2 Metin Akgun,3 Esra Uzaslan,4 Abdullah Sayiner5 1Department of Chest Diseases, Dokuz Eylül University Medical Faculty, Izmir, Turkey; 2Department of Medical Management, Novartis Pharmaceuticals, Istanbul, Turkey; 3Department of Chest Diseases, Atatürk University Medical Faculty, Erzurum, Turkey; 4Department of Chest Diseases, Uludağ University Medical Faculty, Bursa, Turkey; 5Department of Chest Diseases, Ege University Medical Faculty, Izmir, Turkey Purpose: COPD diagnosis is mainly based on clinical judgment of physicians. Physicians do not also refer to COPD guidelines in their daily practice. This study aimed to assess attitudes of physicians regarding COPD diagnosis, treatment, and follow-up and to identify the factors influencing physicians’ decisions in clinical practice. Patients and methods: Fifty physicians were selected from 12 EuroStat NUTS 2 regions and asked to assess seven fictitious case scenarios. The following five scenarios described patients with COPD: Case Global Initiative for Chronic Obstructive Lung Disease (GOLD) A-smoker and Case GOLD A-nonsmoker were previously undiagnosed patients presenting with dyspnea, Case GOLD D-smoker and GOLD B-exsmoker were COPD patients presenting with exacerbation, Case GOLD B-smoker was a previously diagnosed COPD patient with dyspnea in stable phase, Case asthma–COPD overlap syndrome, and Case obesity hypoventilation syndrome. Patients’ history, physical examination findings, pulmonary function tests, and X-ray images were prepared before the study by an experts’ committee and provided to the physicians upon their request, until they reached a final decision. The physicians completed a questionnaire including information about their clinical practices and institutions. Results: According to the GOLD 2015 recommendations, of the physicians, 44% performed guideline-concordant diagnosis in the first five scenarios, who were all COPD patients, and 6% performed guideline-concordant diagnosis in all cases. There was a negative correlation between high workload and making a guideline-concordant diagnosis (P=0.038, rho =-0.417). Even when the physicians made a guideline-concordant diagnosis of COPD, only a minority (10%–22%) used the GOLD classification. Logistic regression analysis revealed that working in a tertiary health care center was a significant factor in favor of establishing a guideline-concordant diagnosis of COPD (P=0.029, OR =6.139 [95% CI: 1.20–31.32]). Conclusion: Management of COPD patients in Turkey does not generally follow the GOLD criteria but is rather based on physicians’ clinical experience. Heavy workload appears to adversely affect the correctness of clinical decisions. Keywords: COPD, practice pattern, real-life scenario, physician decision, GOLD criteria Chronic obstructive pulmonary disease practice pattern real-life scenario physician decision GOLD criteria Diseases of the respiratory system Konya A verfasserin aut Akgun M verfasserin aut Uzaslan E verfasserin aut Sayiner A verfasserin aut In International Journal of COPD Dove Medical Press, 2009 (2018), Seite 2751-2758 (DE-627)504104357 (DE-600)2212419-6 11782005 nnns year:2018 pages:2751-2758 https://doaj.org/article/55729487234543418e98833ca0b3e4ce kostenfrei https://www.dovepress.com/a-case-scenario-study-for-the-assessment-of-physicians-behavior-in-the-peer-reviewed-article-COPD kostenfrei https://doaj.org/toc/1178-2005 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 2018 2751-2758
allfieldsGer	(DE-627)DOAJ012565105 (DE-599)DOAJ55729487234543418e98833ca0b3e4ce DE-627 ger DE-627 rakwb eng RC705-779 Kilinc O verfasserin aut A case scenario study for the assessment of physician’s behavior in the management of COPD: the WHY study 2018 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Oguz Kilinc,1 Aylin Konya,2 Metin Akgun,3 Esra Uzaslan,4 Abdullah Sayiner5 1Department of Chest Diseases, Dokuz Eylül University Medical Faculty, Izmir, Turkey; 2Department of Medical Management, Novartis Pharmaceuticals, Istanbul, Turkey; 3Department of Chest Diseases, Atatürk University Medical Faculty, Erzurum, Turkey; 4Department of Chest Diseases, Uludağ University Medical Faculty, Bursa, Turkey; 5Department of Chest Diseases, Ege University Medical Faculty, Izmir, Turkey Purpose: COPD diagnosis is mainly based on clinical judgment of physicians. Physicians do not also refer to COPD guidelines in their daily practice. This study aimed to assess attitudes of physicians regarding COPD diagnosis, treatment, and follow-up and to identify the factors influencing physicians’ decisions in clinical practice. Patients and methods: Fifty physicians were selected from 12 EuroStat NUTS 2 regions and asked to assess seven fictitious case scenarios. The following five scenarios described patients with COPD: Case Global Initiative for Chronic Obstructive Lung Disease (GOLD) A-smoker and Case GOLD A-nonsmoker were previously undiagnosed patients presenting with dyspnea, Case GOLD D-smoker and GOLD B-exsmoker were COPD patients presenting with exacerbation, Case GOLD B-smoker was a previously diagnosed COPD patient with dyspnea in stable phase, Case asthma–COPD overlap syndrome, and Case obesity hypoventilation syndrome. Patients’ history, physical examination findings, pulmonary function tests, and X-ray images were prepared before the study by an experts’ committee and provided to the physicians upon their request, until they reached a final decision. The physicians completed a questionnaire including information about their clinical practices and institutions. Results: According to the GOLD 2015 recommendations, of the physicians, 44% performed guideline-concordant diagnosis in the first five scenarios, who were all COPD patients, and 6% performed guideline-concordant diagnosis in all cases. There was a negative correlation between high workload and making a guideline-concordant diagnosis (P=0.038, rho =-0.417). Even when the physicians made a guideline-concordant diagnosis of COPD, only a minority (10%–22%) used the GOLD classification. Logistic regression analysis revealed that working in a tertiary health care center was a significant factor in favor of establishing a guideline-concordant diagnosis of COPD (P=0.029, OR =6.139 [95% CI: 1.20–31.32]). Conclusion: Management of COPD patients in Turkey does not generally follow the GOLD criteria but is rather based on physicians’ clinical experience. Heavy workload appears to adversely affect the correctness of clinical decisions. Keywords: COPD, practice pattern, real-life scenario, physician decision, GOLD criteria Chronic obstructive pulmonary disease practice pattern real-life scenario physician decision GOLD criteria Diseases of the respiratory system Konya A verfasserin aut Akgun M verfasserin aut Uzaslan E verfasserin aut Sayiner A verfasserin aut In International Journal of COPD Dove Medical Press, 2009 (2018), Seite 2751-2758 (DE-627)504104357 (DE-600)2212419-6 11782005 nnns year:2018 pages:2751-2758 https://doaj.org/article/55729487234543418e98833ca0b3e4ce kostenfrei https://www.dovepress.com/a-case-scenario-study-for-the-assessment-of-physicians-behavior-in-the-peer-reviewed-article-COPD kostenfrei https://doaj.org/toc/1178-2005 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 2018 2751-2758
allfieldsSound	(DE-627)DOAJ012565105 (DE-599)DOAJ55729487234543418e98833ca0b3e4ce DE-627 ger DE-627 rakwb eng RC705-779 Kilinc O verfasserin aut A case scenario study for the assessment of physician’s behavior in the management of COPD: the WHY study 2018 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Oguz Kilinc,1 Aylin Konya,2 Metin Akgun,3 Esra Uzaslan,4 Abdullah Sayiner5 1Department of Chest Diseases, Dokuz Eylül University Medical Faculty, Izmir, Turkey; 2Department of Medical Management, Novartis Pharmaceuticals, Istanbul, Turkey; 3Department of Chest Diseases, Atatürk University Medical Faculty, Erzurum, Turkey; 4Department of Chest Diseases, Uludağ University Medical Faculty, Bursa, Turkey; 5Department of Chest Diseases, Ege University Medical Faculty, Izmir, Turkey Purpose: COPD diagnosis is mainly based on clinical judgment of physicians. Physicians do not also refer to COPD guidelines in their daily practice. This study aimed to assess attitudes of physicians regarding COPD diagnosis, treatment, and follow-up and to identify the factors influencing physicians’ decisions in clinical practice. Patients and methods: Fifty physicians were selected from 12 EuroStat NUTS 2 regions and asked to assess seven fictitious case scenarios. The following five scenarios described patients with COPD: Case Global Initiative for Chronic Obstructive Lung Disease (GOLD) A-smoker and Case GOLD A-nonsmoker were previously undiagnosed patients presenting with dyspnea, Case GOLD D-smoker and GOLD B-exsmoker were COPD patients presenting with exacerbation, Case GOLD B-smoker was a previously diagnosed COPD patient with dyspnea in stable phase, Case asthma–COPD overlap syndrome, and Case obesity hypoventilation syndrome. Patients’ history, physical examination findings, pulmonary function tests, and X-ray images were prepared before the study by an experts’ committee and provided to the physicians upon their request, until they reached a final decision. The physicians completed a questionnaire including information about their clinical practices and institutions. Results: According to the GOLD 2015 recommendations, of the physicians, 44% performed guideline-concordant diagnosis in the first five scenarios, who were all COPD patients, and 6% performed guideline-concordant diagnosis in all cases. There was a negative correlation between high workload and making a guideline-concordant diagnosis (P=0.038, rho =-0.417). Even when the physicians made a guideline-concordant diagnosis of COPD, only a minority (10%–22%) used the GOLD classification. Logistic regression analysis revealed that working in a tertiary health care center was a significant factor in favor of establishing a guideline-concordant diagnosis of COPD (P=0.029, OR =6.139 [95% CI: 1.20–31.32]). Conclusion: Management of COPD patients in Turkey does not generally follow the GOLD criteria but is rather based on physicians’ clinical experience. Heavy workload appears to adversely affect the correctness of clinical decisions. Keywords: COPD, practice pattern, real-life scenario, physician decision, GOLD criteria Chronic obstructive pulmonary disease practice pattern real-life scenario physician decision GOLD criteria Diseases of the respiratory system Konya A verfasserin aut Akgun M verfasserin aut Uzaslan E verfasserin aut Sayiner A verfasserin aut In International Journal of COPD Dove Medical Press, 2009 (2018), Seite 2751-2758 (DE-627)504104357 (DE-600)2212419-6 11782005 nnns year:2018 pages:2751-2758 https://doaj.org/article/55729487234543418e98833ca0b3e4ce kostenfrei https://www.dovepress.com/a-case-scenario-study-for-the-assessment-of-physicians-behavior-in-the-peer-reviewed-article-COPD kostenfrei https://doaj.org/toc/1178-2005 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 2018 2751-2758
language	English
source	In International Journal of COPD (2018), Seite 2751-2758 year:2018 pages:2751-2758
sourceStr	In International Journal of COPD (2018), Seite 2751-2758 year:2018 pages:2751-2758
format_phy_str_mv	Article
institution	findex.gbv.de
topic_facet	Chronic obstructive pulmonary disease practice pattern real-life scenario physician decision GOLD criteria Diseases of the respiratory system
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container_title	International Journal of COPD
authorswithroles_txt_mv	Kilinc O @@aut@@ Konya A @@aut@@ Akgun M @@aut@@ Uzaslan E @@aut@@ Sayiner A @@aut@@
publishDateDaySort_date	2018-01-01T00:00:00Z
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Physicians do not also refer to COPD guidelines in their daily practice. This study aimed to assess attitudes of physicians regarding COPD diagnosis, treatment, and follow-up and to identify the factors influencing physicians&rsquo; decisions in clinical practice. Patients and methods: Fifty physicians were selected from 12 EuroStat NUTS 2 regions and asked to assess seven fictitious case scenarios. The following five scenarios described patients with COPD: Case Global Initiative for Chronic Obstructive Lung Disease (GOLD) A-smoker and Case GOLD A-nonsmoker were previously undiagnosed patients presenting with dyspnea, Case GOLD D-smoker and GOLD B-exsmoker were COPD patients presenting with exacerbation, Case GOLD B-smoker was a previously diagnosed COPD patient with dyspnea in stable phase, Case asthma&ndash;COPD overlap syndrome, and Case obesity hypoventilation syndrome. Patients&rsquo; history, physical examination findings, pulmonary function tests, and X-ray images were prepared before the study by an experts&rsquo; committee and provided to the physicians upon their request, until they reached a final decision. The physicians completed a questionnaire including information about their clinical practices and institutions. Results: According to the GOLD 2015 recommendations, of the physicians, 44% performed guideline-concordant diagnosis in the first five scenarios, who were all COPD patients, and 6% performed guideline-concordant diagnosis in all cases. There was a negative correlation between high workload and making a guideline-concordant diagnosis (P=0.038, rho =-0.417). Even when the physicians made a guideline-concordant diagnosis of COPD, only a minority (10%&ndash;22%) used the GOLD classification. Logistic regression analysis revealed that working in a tertiary health care center was a significant factor in favor of establishing a guideline-concordant diagnosis of COPD (P=0.029, OR =6.139 [95% CI: 1.20&ndash;31.32]). Conclusion: Management of COPD patients in Turkey does not generally follow the GOLD criteria but is rather based on physicians&rsquo; clinical experience. Heavy workload appears to adversely affect the correctness of clinical decisions. 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callnumber-first	R - Medicine
author	Kilinc O
spellingShingle	Kilinc O misc RC705-779 misc Chronic obstructive pulmonary disease misc practice pattern misc real-life scenario misc physician decision misc GOLD criteria misc Diseases of the respiratory system A case scenario study for the assessment of physician’s behavior in the management of COPD: the WHY study
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topic_title	RC705-779 A case scenario study for the assessment of physician’s behavior in the management of COPD: the WHY study Chronic obstructive pulmonary disease practice pattern real-life scenario physician decision GOLD criteria
topic	misc RC705-779 misc Chronic obstructive pulmonary disease misc practice pattern misc real-life scenario misc physician decision misc GOLD criteria misc Diseases of the respiratory system
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title	A case scenario study for the assessment of physician’s behavior in the management of COPD: the WHY study
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title_full	A case scenario study for the assessment of physician’s behavior in the management of COPD: the WHY study
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author_browse	Kilinc O Konya A Akgun M Uzaslan E Sayiner A
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title_sort	case scenario study for the assessment of physician’s behavior in the management of copd: the why study
callnumber	RC705-779
title_auth	A case scenario study for the assessment of physician’s behavior in the management of COPD: the WHY study
abstract	Oguz Kilinc,1 Aylin Konya,2 Metin Akgun,3 Esra Uzaslan,4 Abdullah Sayiner5 1Department of Chest Diseases, Dokuz Eylül University Medical Faculty, Izmir, Turkey; 2Department of Medical Management, Novartis Pharmaceuticals, Istanbul, Turkey; 3Department of Chest Diseases, Atatürk University Medical Faculty, Erzurum, Turkey; 4Department of Chest Diseases, Uludağ University Medical Faculty, Bursa, Turkey; 5Department of Chest Diseases, Ege University Medical Faculty, Izmir, Turkey Purpose: COPD diagnosis is mainly based on clinical judgment of physicians. Physicians do not also refer to COPD guidelines in their daily practice. This study aimed to assess attitudes of physicians regarding COPD diagnosis, treatment, and follow-up and to identify the factors influencing physicians’ decisions in clinical practice. Patients and methods: Fifty physicians were selected from 12 EuroStat NUTS 2 regions and asked to assess seven fictitious case scenarios. The following five scenarios described patients with COPD: Case Global Initiative for Chronic Obstructive Lung Disease (GOLD) A-smoker and Case GOLD A-nonsmoker were previously undiagnosed patients presenting with dyspnea, Case GOLD D-smoker and GOLD B-exsmoker were COPD patients presenting with exacerbation, Case GOLD B-smoker was a previously diagnosed COPD patient with dyspnea in stable phase, Case asthma–COPD overlap syndrome, and Case obesity hypoventilation syndrome. Patients’ history, physical examination findings, pulmonary function tests, and X-ray images were prepared before the study by an experts’ committee and provided to the physicians upon their request, until they reached a final decision. The physicians completed a questionnaire including information about their clinical practices and institutions. Results: According to the GOLD 2015 recommendations, of the physicians, 44% performed guideline-concordant diagnosis in the first five scenarios, who were all COPD patients, and 6% performed guideline-concordant diagnosis in all cases. There was a negative correlation between high workload and making a guideline-concordant diagnosis (P=0.038, rho =-0.417). Even when the physicians made a guideline-concordant diagnosis of COPD, only a minority (10%–22%) used the GOLD classification. Logistic regression analysis revealed that working in a tertiary health care center was a significant factor in favor of establishing a guideline-concordant diagnosis of COPD (P=0.029, OR =6.139 [95% CI: 1.20–31.32]). Conclusion: Management of COPD patients in Turkey does not generally follow the GOLD criteria but is rather based on physicians’ clinical experience. Heavy workload appears to adversely affect the correctness of clinical decisions. Keywords: COPD, practice pattern, real-life scenario, physician decision, GOLD criteria
abstractGer	Oguz Kilinc,1 Aylin Konya,2 Metin Akgun,3 Esra Uzaslan,4 Abdullah Sayiner5 1Department of Chest Diseases, Dokuz Eylül University Medical Faculty, Izmir, Turkey; 2Department of Medical Management, Novartis Pharmaceuticals, Istanbul, Turkey; 3Department of Chest Diseases, Atatürk University Medical Faculty, Erzurum, Turkey; 4Department of Chest Diseases, Uludağ University Medical Faculty, Bursa, Turkey; 5Department of Chest Diseases, Ege University Medical Faculty, Izmir, Turkey Purpose: COPD diagnosis is mainly based on clinical judgment of physicians. Physicians do not also refer to COPD guidelines in their daily practice. This study aimed to assess attitudes of physicians regarding COPD diagnosis, treatment, and follow-up and to identify the factors influencing physicians’ decisions in clinical practice. Patients and methods: Fifty physicians were selected from 12 EuroStat NUTS 2 regions and asked to assess seven fictitious case scenarios. The following five scenarios described patients with COPD: Case Global Initiative for Chronic Obstructive Lung Disease (GOLD) A-smoker and Case GOLD A-nonsmoker were previously undiagnosed patients presenting with dyspnea, Case GOLD D-smoker and GOLD B-exsmoker were COPD patients presenting with exacerbation, Case GOLD B-smoker was a previously diagnosed COPD patient with dyspnea in stable phase, Case asthma–COPD overlap syndrome, and Case obesity hypoventilation syndrome. Patients’ history, physical examination findings, pulmonary function tests, and X-ray images were prepared before the study by an experts’ committee and provided to the physicians upon their request, until they reached a final decision. The physicians completed a questionnaire including information about their clinical practices and institutions. Results: According to the GOLD 2015 recommendations, of the physicians, 44% performed guideline-concordant diagnosis in the first five scenarios, who were all COPD patients, and 6% performed guideline-concordant diagnosis in all cases. There was a negative correlation between high workload and making a guideline-concordant diagnosis (P=0.038, rho =-0.417). Even when the physicians made a guideline-concordant diagnosis of COPD, only a minority (10%–22%) used the GOLD classification. Logistic regression analysis revealed that working in a tertiary health care center was a significant factor in favor of establishing a guideline-concordant diagnosis of COPD (P=0.029, OR =6.139 [95% CI: 1.20–31.32]). Conclusion: Management of COPD patients in Turkey does not generally follow the GOLD criteria but is rather based on physicians’ clinical experience. Heavy workload appears to adversely affect the correctness of clinical decisions. Keywords: COPD, practice pattern, real-life scenario, physician decision, GOLD criteria
abstract_unstemmed	Oguz Kilinc,1 Aylin Konya,2 Metin Akgun,3 Esra Uzaslan,4 Abdullah Sayiner5 1Department of Chest Diseases, Dokuz Eylül University Medical Faculty, Izmir, Turkey; 2Department of Medical Management, Novartis Pharmaceuticals, Istanbul, Turkey; 3Department of Chest Diseases, Atatürk University Medical Faculty, Erzurum, Turkey; 4Department of Chest Diseases, Uludağ University Medical Faculty, Bursa, Turkey; 5Department of Chest Diseases, Ege University Medical Faculty, Izmir, Turkey Purpose: COPD diagnosis is mainly based on clinical judgment of physicians. Physicians do not also refer to COPD guidelines in their daily practice. This study aimed to assess attitudes of physicians regarding COPD diagnosis, treatment, and follow-up and to identify the factors influencing physicians’ decisions in clinical practice. Patients and methods: Fifty physicians were selected from 12 EuroStat NUTS 2 regions and asked to assess seven fictitious case scenarios. The following five scenarios described patients with COPD: Case Global Initiative for Chronic Obstructive Lung Disease (GOLD) A-smoker and Case GOLD A-nonsmoker were previously undiagnosed patients presenting with dyspnea, Case GOLD D-smoker and GOLD B-exsmoker were COPD patients presenting with exacerbation, Case GOLD B-smoker was a previously diagnosed COPD patient with dyspnea in stable phase, Case asthma–COPD overlap syndrome, and Case obesity hypoventilation syndrome. Patients’ history, physical examination findings, pulmonary function tests, and X-ray images were prepared before the study by an experts’ committee and provided to the physicians upon their request, until they reached a final decision. The physicians completed a questionnaire including information about their clinical practices and institutions. Results: According to the GOLD 2015 recommendations, of the physicians, 44% performed guideline-concordant diagnosis in the first five scenarios, who were all COPD patients, and 6% performed guideline-concordant diagnosis in all cases. There was a negative correlation between high workload and making a guideline-concordant diagnosis (P=0.038, rho =-0.417). Even when the physicians made a guideline-concordant diagnosis of COPD, only a minority (10%–22%) used the GOLD classification. Logistic regression analysis revealed that working in a tertiary health care center was a significant factor in favor of establishing a guideline-concordant diagnosis of COPD (P=0.029, OR =6.139 [95% CI: 1.20–31.32]). Conclusion: Management of COPD patients in Turkey does not generally follow the GOLD criteria but is rather based on physicians’ clinical experience. Heavy workload appears to adversely affect the correctness of clinical decisions. Keywords: COPD, practice pattern, real-life scenario, physician decision, GOLD criteria
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title_short	A case scenario study for the assessment of physician’s behavior in the management of COPD: the WHY study
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