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Title: Case finding for chronic obstructive pulmonary disease (COPD) in primary care : finding the optimal approach
Author: Haroon, Shamil Macbool Mohamed
ISNI:       0000 0004 5358 9453
Awarding Body: University of Birmingham
Current Institution: University of Birmingham
Date of Award: 2015
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Chronic obstructive pulmonary disease (COPD) is an important cause of morbidity and mortality but widely underdiagnosed. This thesis explores methods to improve case finding for COPD in primary care. It includes two systematic reviews - the first evaluated the diagnostic accuracy of screening tests and showed that handheld flow meters are more accurate than the COPD Diagnostic Questionnaire. The second evaluated the comparative effectiveness of different case finding strategies and found that inviting symptomatic ever smokers for a screening assessment may be more efficient than inviting all ever smokers directly for diagnostic spirometry. The thesis then reports the development and external validation of two risk prediction models for COPD using data from electronic health records and a cluster randomised controlled trial. These models can be used to assess the risk of undiagnosed COPD to help target patients for case finding and can potentially be integrated with clinical information systems. Finally, primary care providers were interviewed to explore their views on case finding for COPD, including potential benefits and harms, as well as barriers and facilitators. This suggests that more training and support for community respiratory services may be needed in order to improve the timely diagnosis of COPD.
Supervisor: Not available Sponsor: National Institute for Health Research (NIHR)
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available
Keywords: RA Public aspects of medicine ; RC Internal medicine