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The AIMAR recommendations for early diagnosis of chronic obstructive respiratory disease based on the WHO/GARD model*

Overview of attention for article published in Multidisciplinary Respiratory Medicine, September 2014
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Title
The AIMAR recommendations for early diagnosis of chronic obstructive respiratory disease based on the WHO/GARD model*
Published in
Multidisciplinary Respiratory Medicine, September 2014
DOI 10.1186/2049-6958-9-46
Pubmed ID
Authors

Stefano Nardini, Isabella Annesi-Maesano, Mario Del Donno, Maurizio Delucchi, Germano Bettoncelli, Vincenzo Lamberti, Carlo Patera, Mario Polverino, Antonio Russo, Carlo Santoriello, Patrizio Soverina

Abstract

Respiratory diseases in Italy already now represent an emergency (they are the 3(rd) ranking cause of death in the world, and the 2(nd) if Lung cancer is included). In countries similar to our own, they result as the principal cause for a visit to the general practitioner (GP) and the second main cause after injury for recourse to Emergency Care. Their frequency is probably higher than estimated (given that respiratory diseases are currently underdiagnosed). The trend is towards a further increase due to epidemiologic and demographic factors (foremost amongst which are the widespread diffusion of cigarette smoking, the increasing mean age of the general population, immigration, and pollution). Within the more general problem of chronic disease care, chronic respiratory diseases (CRDs) constitute one of the four national priorities in that they represent an important burden for society in terms of mortality, invalidity, and direct healthcare costs. The strategy suggested by the World Health Organization (WHO) is an integrated approach consisting of three goals: inform about health, reduce risk exposure, improve patient care. The three goals are translated into practice in the three areas of prevention (1-primary, 2-secondary, 3-tertiary) as: 1) actions of primary (universal) prevention targeted at the general population with the aim to control the causes of disease, and actions of Predictive Medicine - again addressing the general population but aimed at measuring the individual's risk for disease insurgence; 2) actions of early diagnosis targeted at groups or - more precisely - subgroups identified as at risk; 3) continuous improvement and integration of care and rehabilitation support - destined at the greatest possible number of patients, at all stages of disease severity. In Italy, COPD care is generally still inadequate. Existing guidelines, institutional and non-institutional, are inadequately implemented: the international guidelines are not always adaptable to the Italian context; the document of the Agency for Regional Healthcare Services (AGE.NA.S) is a more suited compendium for consultation, and the recent joint statement on integrated COPD management of the three major Italian scientific Associations in the respiratory area together with the contribution of a Society of General Medicine deals prevalently with some critical issues (appropriateness of diagnosis, pharmacological treatment, rehabilitation, continuing care); also the document "Care Continuity: Chronic Obstructive Pulmonary Disease (COPD)" of the Global Alliance against chronic Respiratory Diseases (GARD)-Italy does not treat in depth the issue of early diagnosis. The present document - produced by the AIMAR (Interdisciplinary Association for Research in Lung Disease) Task Force for early diagnosis of chronic respiratory disease based on the WHO/GARD model and on available evidence and expertise -after a general examination of the main epidemiologic aspects, proposes to integrate the above-mentioned existing documents. In particular: a) it formally indicates on the basis of the available evidence the modalities and the instruments necessary for carrying out secondary prevention at the primary care level (a pro-active,'case-finding'approach; assessment of the individual's level of risk of COPD; use of short questionnaires for an initial screening based on symptoms; use of simple spirometry for the second level of screening); b) it identifies possible ways of including these activities within primary care practice; c) it places early diagnosis within the "systemic", consequential management of chronic respiratory diseases, which will be briefly described with the aid of schemes taken from the Italian and international reference documents.

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Mendeley readers

The data shown below were compiled from readership statistics for 86 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United Kingdom 1 1%
Spain 1 1%
India 1 1%
South Africa 1 1%
Unknown 82 95%

Demographic breakdown

Readers by professional status Count As %
Student > Master 18 21%
Researcher 15 17%
Student > Bachelor 9 10%
Student > Ph. D. Student 8 9%
Student > Doctoral Student 7 8%
Other 17 20%
Unknown 12 14%
Readers by discipline Count As %
Medicine and Dentistry 37 43%
Nursing and Health Professions 11 13%
Agricultural and Biological Sciences 4 5%
Economics, Econometrics and Finance 4 5%
Social Sciences 3 3%
Other 13 15%
Unknown 14 16%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 09 December 2014.
All research outputs
#9,958,783
of 12,440,396 outputs
Outputs from Multidisciplinary Respiratory Medicine
#159
of 205 outputs
Outputs of similar age
#189,838
of 281,756 outputs
Outputs of similar age from Multidisciplinary Respiratory Medicine
#29
of 34 outputs
Altmetric has tracked 12,440,396 research outputs across all sources so far. This one is in the 11th percentile – i.e., 11% of other outputs scored the same or lower than it.
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