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General practitioners and rare lung diseases: a task force for the development of rare lung diseases educational material

Bruno Balbi, Davide Vallese, Niels Chavannes, Bjorn Stallberg, Paola Baiardi on behalf of the Task Force members
Breathe 2016 12: 341-348; DOI: 10.1183/20734735.008816
Bruno Balbi
1Pulmonary Rehabilitation, Istituti Clinici Scientifici Maugeri, IRCCS, Veruno, Italy
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  • For correspondence: bruno.balbi@fsm.it
Davide Vallese
1Pulmonary Rehabilitation, Istituti Clinici Scientifici Maugeri, IRCCS, Veruno, Italy
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Niels Chavannes
2Dept of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
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Bjorn Stallberg
3Dept of Public Health and Caring Sciences, Family Medicine and Preventive Medicine, Uppsala University, Uppsala, Sweden
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Paola Baiardi
4Scientific Direction, Istituti Clinici Scientifici Maugeri, IRCCS, Pavia, Italy
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  • Article
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Figures

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  • Figure 1
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    Figure 1

    Proportion of the different rare lung disease among patients of general practitioners. IPF: idiopathic pulmonary fibrosis.

Tables

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  • Table 1

    Adult questionnaire: GP distribution by country

    CountryRespondents n
    Italy127
    Portugal10
    Slovenia7
    UK4
    Spain2
    Netherlands2
    Turkey1
    Switzerland1
    Sweden1
    Poland1
    Finland1
    Pakistan1
    Mexico1
    India2
    Germany1
    Egypt1
    Cyprus1
    Unknown6
  • Table 2

    Paediatric questionnaire: GP distribution by country

    CountryRespondents n
    Italy28
    Portugal8
    UK3
    Netherlands2
    Sweden1
    Slovenia1
    Switzerland1
    Egypt1
    Pakistan1
  • Table 3

    Number of patients (adult and paediatric) per GP

    Patients in GP’s careGPs n% of all GPs#% of GPs who responded to the question
    Data missing84.1
    >15007337.238.83
    1500–10016633.735.11
    1000–5013819.420.21
    500–250115.65.85
    Total196100.0100.0
  • Table 4

    Proportion of paediatric patients (aged 0–17 years) in the care of GPs with both adult and paediatric patients

    Paediatric patients %GPs n% of all GPs#% of GPs who responded to the question
    Data missing8744.4
    0136.611.93
    5–104724.043.12
    10–15126.111.01
    15–20115.610.09
    50–1002613.323.85
    Total196100.0100.0
  • Table 5

    Rare lung diseases present among patients of GPs surveyed

    Rare lung diseasePatients n
    Sarcoidosis15
    CF14
    Idiopathic pulmonary fibrosis13
    AATD10
    LAM7
    Other rare lung diseases#
     Pulmonary alveolar proteinosis6
     Bronchiectasis6
     PAH5
     Interstitial lung disease3
     Langerhans cell histiocytosis2
     Others28
    Total109
    • #: n=50.

  • Table 6

    Results of the questionnaire relating to AATD

    Wrong responses
    What are the main symptoms/signs/manifestations that could be suggestive AATD?
     Wrong option: osteomyelitis53%
     All other options: grading=010 (0–53)%
    What type of pattern of lung/respiratory function test would be suggestive of AATD?
     Wrong option: restrictive pattern68%
     All other options: grading=011 (2.5–68)%
    What type of blood lab examination is suggestive of AATD?
     Wrong option: increased peripheral blood α1-antitrypsin21%
     All other options: grading=010 (5–23)%
    • Data are presented as median (min–max), unless otherwise stated. Definition of wrong option/answer: responses were considered wrong when a grade >1 was attributed. The percentage of wrong responses was calculated on valid responses (i.e. after missing and “I don’t know” responses were excluded) and is the sum of two contributions. Wrong option: responses were considered wrong when a grade >0 was attributed to the wrong option in the questionnaire. All other options: responses were considered wrong when a grade = 0 was attributed to the other options in the questionnaire. The summary figure is reported in terms of median (minimum–maximum) of the percentages of wrong responses to each option.

  • Table 7

    Results of the paediatric questionnaire relating to PAH and LAM

    Wrong responses
    What are the main symptoms/manifestations that could be suggestive of PAH?
     Wrong option: vision abnormalities62%
     All other options: grading=010 (1–62)%
    What are the main findings that could be suggestive of PAH?
     Wrong option: loose shoulders49%
     All other options: grading=04 (0–49)%
    What type of pattern of lung/respiratory function abnormalities would be suggestive of PAH?
     Wrong option: sleep apnoea/hypopnea84%
     All other options: grading=026 (1–84)%
    What are the main symptoms/signs/manifestations that could be suggestive of LAM?
     Wrong option: erythema nodosum64%
     All other options: grading=09 (1–64)%
    What type of pattern of lung function test would be suggestive of LAM?
     Wrong option: respiratory acidosis81%
     All other options: grading=011 (3–81)%
    What type of finding at imaging studies would be suggestive of LAM?
     Wrong option: cerebrovascular abnormalities on brain CT60%
     All other options: grading=012 (3–61)%
    • Data are presented as median (min–max), unless otherwise stated. The percentage of wrong responses was calculated on valid responses (i.e. after missing and “I don’t know” responses were excluded) and is the sum of two contributions. Wrong option: responses were considered wrong when a grade >0 was attributed to the wrong option in the questionnaire. All other options: responses were considered wrong when a grade = 0 was attributed to the other options in the questionnaire. The summary figure is reported in terms of median (minimum–maximum) of the percentages of wrong responses to each option. CT: computed tomography.

  • Table 8

    Results of the questionnaire relating to rare lung diseases

    Wrong responses
    Which findings of imaging suggest CF?
     Wrong option: bilateral pleural effusion79%
     All other options: grading=05 (0–13)%
    Which findings of imaging suggest PCD?
     Wrong option: biliary stones78%
     All other options: grading=00 (0–18)%
    Which investigations should be undertaken to diagnose PCD?
     Wrong option: arterial blood gas analysis83%
     All other options: grading=05 (0–9)%
    What are the main symptoms/signs/manifestations that could be suggestive of lung disease in a child with immunodeficiency?
     Wrong option: hyperhidrosis88%
     All other options: grading=00 (0–8)%
    What are the main physical signs and findings that could be suggestive of lung disease due to immunodeficiency?
     Wrong option: normal physical examination70%
     All other options: grading=05 (0–22)%
    • Data are presented as median (min–max), unless otherwise stated. The percentage of wrong responses was calculated on valid responses (i.e. after missing and “I don’t know” responses were excluded) and is the sum of two contributions. Wrong option: responses were considered wrong when a grade >0 was attributed to the wrong option in the questionnaire. All other options: responses were considered wrong when a grade = 0 was attributed to the other options in the questionnaire. The summary figure is reported in terms of median (minimum–maximum) of the percentages of wrong responses to each option.

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General practitioners and rare lung diseases: a task force for the development of rare lung diseases educational material
Bruno Balbi, Davide Vallese, Niels Chavannes, Bjorn Stallberg, Paola Baiardi
Breathe Dec 2016, 12 (4) 341-348; DOI: 10.1183/20734735.008816

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General practitioners and rare lung diseases: a task force for the development of rare lung diseases educational material
Bruno Balbi, Davide Vallese, Niels Chavannes, Bjorn Stallberg, Paola Baiardi
Breathe Dec 2016, 12 (4) 341-348; DOI: 10.1183/20734735.008816
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