Effect of pulmonary function testing on the management of acute XXXX .

@entity1 @entity565 @entity748 @entity1224
BACKGROUND: Routine pulmonary function testing has been recommended as part of the emergency department management of acute @entity565 despite the lack of evidence demonstrating the necessity for these measurements. The purpose of this study was to assess the physician's ability to estimate pulmonary function in @entity1 with acute @entity565 and to determine the effect that pulmonary function testing has on @entity1 management. METHODS: Emergency medicine physicians estimated pulmonary function in adult @entity748 @entity1 prior to spirometry. The estimations and spirometry were repeated after 1 hour and again at discharge. The physicians noted their treatment plan before and after receiving the results of pulmonary function testing. RESULTS: Ninety-eight @entity1 were enrolled in the study. There was only moderate correlation between pretreatment estimates of pulmonary function and the actual value (r = .41). On average, physicians underestimated the degree of pretreatment @entity1224 (as percentage of predicted normal value) by 8.1 +/- 16.0 percentage points. Knowledge of the pulmonary function test results changed management in 20.4% of @entity1 . The most common change was an alteration in the decision to continue treatment after 3 hours. CONCLUSIONS: Physicians tend to underestimate the degree of @entity1224 in acute @entity565 , particularly on initial assessment. Since the availability of pulmonary function tests changes management in a significant number of @entity1 , routine pulmonary function testing is recommended as part of the assessment and monitoring of acute @entity565 .
