This desktop helper No 5 May 2016 describes a tool designed to support general practitioners (GPs) in diagnosing their patients with suspicion of obstructive respiratory disease. Misdiagnoses and under-diagnoses of asthma and COPD are common. Many current diagnostic tools are not based on real-life data and hence lack generalisability to clinical practice. The tool was developed by analysing real-life data from 9,297 primary care patients (45% male, mean age 53±17 years) who were diagnosed by a pulmonologist.

This desktop helper can be used to predict a working diagnosis in primary care patients along with an estimation of the probability. Initiating and monitoring response to treatment is the next step. The predicted working diagnosis should be evaluated 3 months after diagnosis and treatment onset to confirm or reject the working diagnosis. This tool is suitable for:

• Regular primary care patients, including those with comorbidities

• Patients older than 15 years

• Patients with respiratory complaints suggestive of obstructive airways disease

• Patients with available spirometry data including reversibility testing


Author: Esther Metting

Editor: Hilary Pinnock

No conflicts of interest have been declared.

Writing funded by IPCRG; Novartis Pharma B.V funded the typesetting, printing and postage.

This desktop helper is advisory; it is intended for general use and should not be regarded as applicable to a specific case.
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Creative Commons Licence Attribution-NonCommercial-ShareAlike

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Link to full paper:

Metting EI, Riemersma RA, Kocks JH, Piersma-Wichers MG, Sanderman R, van der Molen T. Feasibility and effectiveness of an Asthma/COPD service for primary care: a cross-sectional baseline description and longitudinal results. Npj Prim Care Respir Med [Internet]. Primary Care Respiratory Society UK/Macmillan Publishers Limited; 2015 Jan 8;25:14101. Available from:

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