Acceptability and feasibility of a chronic breathlessness diagnostic clinical algorithm in Australian primary care.

IF 1.6 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Australian Journal of General Practice Pub Date : 2024-11-01 DOI:10.31128/AJGP-11-23-7009

Anthony Paulo Sunjaya, Allison Martin, Clare Arnott, Gian Luca Di Tanna, Chris Gianacas, Guy Marks, Christine Jenkins

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引用次数: 0

Abstract

Background and objectives: Chronic breathlessness is a frequent diagnostic challenge in primary care. Our aim is to evaluate the feasibility of a stepwise breathlessness diagnostic algorithm for primary care.

Method: This mixed-methods study included: (1) a general practitioner (GP) nominal group technique study; (2) focus groups on GPs' views on the algorithm; and (3) analysis of algorithm alignment against patterns of diagnostic referrals and diagnoses of breathlessness presentations (2014-19) from the MedicineInsight primary care electronic health record (EHR) dataset of 1,961,264 patients (405 general practice sites).

Results: All the tests in our algorithm, except for echocardiography, were ranked in the top 10 tests used by most GPs for patients presenting with chronic breathlessness. Themes from the focus group include similarity with current practice and test accessibility. Analysis of EHR diagnostic referrals revealed that all tests in the algorithm are regularly utilised and covered the major tests needed for breathlessness diagnoses recorded.

Discussion: The results of the three studies support the acceptability and feasibility of the clinical algorithm in primary care.

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澳大利亚基层医疗机构对慢性呼吸困难诊断临床算法的可接受性和可行性。

背景和目的：慢性憋气是初级医疗中经常遇到的诊断难题。我们的目的是评估基层医疗机构采用逐步式呼吸困难诊断算法的可行性：这项混合方法研究包括(方法：这项混合方法研究包括：（1）全科医生（GP）名义小组技术研究；（2）焦点小组讨论全科医生对算法的看法；（3）根据来自MedicineInsight初级医疗电子健康记录（EHR）数据集的1961264名患者（405个全科医生站点）的憋气症状诊断转诊和诊断模式（2014-19年）分析算法的一致性：结果：除超声心动图外，我们算法中的所有检查项目均被大多数全科医生列为治疗慢性呼吸困难患者的前 10 大检查项目。焦点小组讨论的主题包括与当前实践的相似性和检验的可及性。对电子病历诊断转诊的分析表明，算法中的所有检验项目都被定期使用，并涵盖了记录的呼吸困难诊断所需的主要检验项目：讨论：三项研究的结果支持了临床算法在初级保健中的可接受性和可行性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Australian Journal of General Practice Medicine-Family Practice

CiteScore

2.80

自引率

4.50%

发文量

284

期刊介绍： The Australian Journal of General Practice (AJGP) aims to provide relevant, evidence-based, clearly articulated information to Australian general practitioners (GPs) to assist them in providing the highest quality patient care, applicable to the varied geographic and social contexts in which GPs work and to all GP roles as clinician, researcher, educator, practice team member and opinion leader. All articles are subject to peer review before they are accepted for publication.