Respiratory diagnoses are aided by new guide

A comprehensive guide to help GPs differentiate between respiratory diseases has been produced by an international group on respiratory medicine.

The guide was developed by the International Primary Care Respiratory Group (IPCRG) and includes detailed questionnaires and diagnostic pathways to lead GPs to a correct diagnosis.

For patients who do appear to have a chronic airways disease, a comprehensive flow chart aids differential diagnosis of asthma, allergic rhinitis and COPD.

One section focuses on differentiating asthma and COPD, which is a 'major challenge' to primary care professionals.

Unlike NICE's guidelines, and in common with the General Practice Airways Group's (GPIAG) guidance (GP, 17 February 2006), reversibility testing to differentiate between the two conditions is advocated.

Score charts are provided to interpret points allocated according to a patient's history and symptoms.

Dr Steve Holmes, Somerset GP and chairman of the GPIAG, said: 'The authors have produced an integrated, evidence-based diagnosis guide.'

Primary Care Respiratory Journal 2006; 15: 20-34

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- Characterise the problem:

A: exclude infectious diseases.

B: exclude non-respiratory causes.

C: establish if it is a chronic condition.

- Consider the patient's age and related illnesses, and investigate possible chronic airways diseases.

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