@article{JTD21903,
author = {Yao C. Huang and Olivia R. Ferry and Scott C. McKenzie and Rayleen V. Bowman and Michael Hamilton and Philip J. Masel and Kwun M. Fong and Ian A. Yang},
title = {Diagnosis of the cause of chronic dyspnoea in primary and tertiary care: characterizing diagnostic confidence},
journal = {Journal of Thoracic Disease},
volume = {10},
number = {6},
year = {2018},
keywords = {},
abstract = {Background: Chronic dyspnoea (breathlessness) in adults is a common symptom, the exact cause of which may be difficult to diagnose on initial presentation. We characterised the diagnostic complexity of chronic dyspnoea in primary care and tertiary care.
Methods: This retrospective observational study screened consecutive referral letters of all adult patients referred to cardiology or respiratory clinics at a tertiary referral hospital, during May to June 2015. For patients referred due to chronic dyspnoea, data were analysed from the initial referral letter and subsequent specialist clinic letters for the 6-month time period after referral.
Results: Of 1,370 patient referrals, 122 patients (mean age 63 y, 55% female) were referred due to chronic dyspnoea. One hundred and five patients (86%) were referred from primary care and 17 (14%) from other hospital clinics. Sixty-one percent were referred with an evident diagnosis (referrer was confident of the initial diagnosis), whereas 39% had non-evident or unclear diagnoses. By 6 months after referral, a definitive final diagnosis had been determined by the specialist clinics in 62% of patients. The majority of patients had been referred appropriately to a cardiology or respiratory clinic, based on the final diagnosis. However, only 26% of diagnoses were fully concordant between the initial referrer diagnosis and the final specialist clinic diagnosis, with 26% being partially concordant and 48% non-concordant. Diagnostic certainty of the referrer was associated with concordance of diagnosis between the referrer and specialist clinic (P},
issn = {2077-6624}, url = {https://jtd.amegroups.org/article/view/21903}
}