The University of Southampton
University of Southampton Institutional Repository

Variation in family physicians' recording of auscultation abnormalities in patients with acute cough is not explained by case mix. A study from 12 European networks

Variation in family physicians' recording of auscultation abnormalities in patients with acute cough is not explained by case mix. A study from 12 European networks
Variation in family physicians' recording of auscultation abnormalities in patients with acute cough is not explained by case mix. A study from 12 European networks
Background: Conflicting data on the diagnostic and prognostic value of auscultation abnormalities may be partly explained by inconsistent use of terminology. Objectives: To describe general practitioners use of chest auscultation abnormality terms for patients presenting with acute cough across Europe, and to explore the influence of geographic location and case mix on use of these terms. Methods: Clinicians recorded whether ?diminished vesicular breathing?, ?wheezes?, ?crackles? and ?rhonchi? were present in an observational study of adults with acute cough in 13 networks in 12 European countries. We describe the use of these terms overall and by network, and used multilevel logistic regression to explore variation by network, controlling for patients? gender, age, comorbidities, smoking status and symptoms. Results: 2345 patients were included. Wheeze was the auscultation abnormality most frequently recorded (20.6% overall) with wide variation by network (range: 8.3?30.8. There was similar variation for other auscultation abnormalities. After controlling for patient characteristics, network was a significant predictor of auscultation abnormalities with odds ratios for location effects ranging from 0.37 to 4.46 for any recorded auscultation abnormality, and from 0.25 to 3.14 for rhonchi. Conclusion: There is important variation in recording chest auscultation abnormalities by general practitioners across Europe, which cannot be explained by differences in patient characteristics. There is a need and opportunity for standardization in the detection and classification of lung sounds.
1381-4788
77-84
Francis, Nick A.
9b610883-605c-4fee-871d-defaa86ccf8e
Melbye, Hasse
be60ca95-b236-48e5-8eb9-c9a153d54a8f
Kelly, Mark J.
738a2267-4c22-4016-96ab-9a2c935e7e35
Cals, Jochen W. L.
ec7f8605-c306-4ce0-a833-a290c963c1cf
Hopstaken, Rogier M.
de6b4144-f13f-4e2b-a40f-999a383ff6e2
Coenen, Samuel
3d0dc4e0-e5ba-4d66-ba92-15900ccc551e
Butler, Christopher
8bf4cace-c34a-4b65-838f-29c2be91e434
Francis, Nick A.
9b610883-605c-4fee-871d-defaa86ccf8e
Melbye, Hasse
be60ca95-b236-48e5-8eb9-c9a153d54a8f
Kelly, Mark J.
738a2267-4c22-4016-96ab-9a2c935e7e35
Cals, Jochen W. L.
ec7f8605-c306-4ce0-a833-a290c963c1cf
Hopstaken, Rogier M.
de6b4144-f13f-4e2b-a40f-999a383ff6e2
Coenen, Samuel
3d0dc4e0-e5ba-4d66-ba92-15900ccc551e
Butler, Christopher
8bf4cace-c34a-4b65-838f-29c2be91e434

Francis, Nick A., Melbye, Hasse, Kelly, Mark J., Cals, Jochen W. L., Hopstaken, Rogier M., Coenen, Samuel and Butler, Christopher (2013) Variation in family physicians' recording of auscultation abnormalities in patients with acute cough is not explained by case mix. A study from 12 European networks. European Journal of General Practice, 19 (2), 77-84. (doi:10.3109/13814788.2012.733690).

Record type: Article

Abstract

Background: Conflicting data on the diagnostic and prognostic value of auscultation abnormalities may be partly explained by inconsistent use of terminology. Objectives: To describe general practitioners use of chest auscultation abnormality terms for patients presenting with acute cough across Europe, and to explore the influence of geographic location and case mix on use of these terms. Methods: Clinicians recorded whether ?diminished vesicular breathing?, ?wheezes?, ?crackles? and ?rhonchi? were present in an observational study of adults with acute cough in 13 networks in 12 European countries. We describe the use of these terms overall and by network, and used multilevel logistic regression to explore variation by network, controlling for patients? gender, age, comorbidities, smoking status and symptoms. Results: 2345 patients were included. Wheeze was the auscultation abnormality most frequently recorded (20.6% overall) with wide variation by network (range: 8.3?30.8. There was similar variation for other auscultation abnormalities. After controlling for patient characteristics, network was a significant predictor of auscultation abnormalities with odds ratios for location effects ranging from 0.37 to 4.46 for any recorded auscultation abnormality, and from 0.25 to 3.14 for rhonchi. Conclusion: There is important variation in recording chest auscultation abnormalities by general practitioners across Europe, which cannot be explained by differences in patient characteristics. There is a need and opportunity for standardization in the detection and classification of lung sounds.

This record has no associated files available for download.

More information

Accepted/In Press date: 12 September 2012
e-pub ahead of print date: 2 April 2013
Published date: 2013

Identifiers

Local EPrints ID: 436298
URI: http://eprints.soton.ac.uk/id/eprint/436298
ISSN: 1381-4788
PURE UUID: c3adca21-1d93-43d7-9d1c-35a89d4e790d
ORCID for Nick A. Francis: ORCID iD orcid.org/0000-0001-8939-7312

Catalogue record

Date deposited: 06 Dec 2019 17:30
Last modified: 09 Jan 2022 04:08

Export record

Altmetrics

Contributors

Author: Nick A. Francis ORCID iD
Author: Hasse Melbye
Author: Mark J. Kelly
Author: Jochen W. L. Cals
Author: Rogier M. Hopstaken
Author: Samuel Coenen
Author: Christopher Butler

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of http://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×