This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

Michael W. Owens, MD; Gary T. Kinasewitz, MD; Ronald S. Lambert, MD; William H. Matthews, MD; D. Keith Payne, MD; Ronald B. George, MD

Arch Intern Med. 1987;147(11):1966-1969.

Abstract
• Spirometry and chest roentgenography are frequently employed to evaluate patients with respiratory problems. To determine their impact on the management of outpatients with lung disease, both tests were performed on 100 consecutive patients (40 men and 60 women; mean age, 52 ±15 years) who returned for reevaluation 16 ±9 weeks after their previous clinic visit. Patients with obstructive (n =45), restrictive (n =35), and mixed (n=20) lung diseases were initially assessed by history and physical examination and classified clinically as improved, stable, or worse. A clinical management plan (CMP) was formulated based on this initial evaluation. Changes in the proposed CMP due to spirographic or roentgenographic results were then noted. None of the 19 patients who were clinically improved and only two (3%) of the 64 clinically stable patients had a change in CMP. In contrast, five (29%) of the 17 patients whose conditions deteriorated clinically had their proposed CMP modified after review of the spirograms and roentgenograms. Therapy was intensified in three of the seven patients whose CMPs were modified, while in the other four, treatment was withheld because results of both tests were unchanged. These results indicate that routine spirograms and chest films have little influence on the CMP of clinically stable patients. However, unexpected roentgenographic and spirometric findings frequently alter the management of the individual whose condition has clinically deteriorated.

(Arch Intern Med 1987;147:1966-1969)

Author Affiliations
From the Cardiopulmonary Research Center, Departments of Medicine (Drs Owens, Kinasewitz, Lambert, Matthews, Payne, and George) and Physiology and Biophysics (Dr Kinasewitz), Louisiana State University School of Medicine, Shreveport.

Footnotes
Accepted for publication Aug 7, 1987.

Reprint requests to the Cardiopulmonary Research Center, Department of Medicine, Louisiana State University Medical Center, PO Box 33932, Shreveport, LA 71130-3932 (Dr Kinasewitz).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

The Importance of Spirometry in the Assessment of Childhood Asthma
Bye et al.
Arch Pediatr Adolesc Med 1992;146:977-978.
ABSTRACT