We have provided patients with diagnosis and treatment advice from their lung assessments using an algorithm It was feasible and in general well appreciated by our patients Metting EI1,2 Van der Berg J1 Van Heijst E3 Kocks JWH1,2 Van der Molen T1,2 e.i.metting@umcg.nl Introduction Previous research by our department has shown that many asthma and COPD patients would like to have more insight in their own medical results. We think that providing patients with easy access to their medical results might enhance self management and hence improve health outcomes. Aim We examined the feasibility of automatically providing patients with their personal results from a lung function assessment. We also evaluated patients’ opinion about these results. Method Setting We included 46 patients (20% male, mean age 61 [range 20-86] years, 41% asthma, 30% COPD) who were referred by their GP for an assessment by an Asthma/COPD-service. In this service, patients are assessed according to a strict protocol and a pulmonologist evaluates the results from the assessment through the Internet. The GP who referred the patient to the AC-service will be provided with diagnosis and treatment advice from the pulmonologist and discusses this with his patient (see figure 1). Providing medical results and advices In this study the involved GPs were asked to discuss the results with their patients within 3 weeks after the assessment by the AC-service. An algorithm was developed to automatically generate a results overview for patients according to the 3 formats below (see table 1). We examined the participants’ opinions and preferences with an evaluation questionnaire and compared the results with illness perceptions and disease severity. Format 1 Format 2 Format 3 Patient rating format 1 (n=32) Overall score: 8.1 (range 5-10)** 94% understood the information in format 1 Patient rating format 2 (n=33) Overall score: 7.7 (range 2-10)** 76-79% understood the spirometry information 81% understood the CCQ/ACQ information Patient rating format 3 (n=33) Overall score: 7.7 (range 4-10)** 91% understood the information Diagnosis and advice Diagnosis Severity Medication advice Inhaler technique Lifestyle advice Link to websites with information Spirometry FVC, FEV1, FEV1/FVC Reversibility Questionnaire Clinical COPD Questionnaire score(CCQ). Only in COPD and ACOS* patients Asthma Control Questionnaire(ACQ) score. Only in asthma and ACOS* patients Lung function curve Predicted lung function curve Patient’s lung function curve Conclusion This study has shown that automatically providing results from lung function tests is feasible and well appreciated by patients. Some patients got worried by the diagnostic results. Therefore extra attention is required when providing patients with their medical results. Results (see also table 1 and 2 for an overview) 72% of the patients returned the evaluation questionnaire (n=33). 97% of participants would like to view their lung function test results again, 82% preferred to view all 3 formats. 76% considered the information to be helpful in dealing with their respiratory symptoms. A minority of participants would like to view their results on the computer instead of on paper (21% and 76% respectively). Information about diagnosis and disease severity caused some patients to feel anxious (respectively 18% and 15%). Especially in uncontrolled asthma patients. 50% of the patients were not informed about the results by their GP. Perceived negative consequences of the disease were related to negative emotions experienced due to the provided assessment results (correlation: 0.374, p=0.032). ¹ University of Groningen University Medical Center Groningen Department of General Practice the Netherlands ² University of Groningen University Medical Center Groningen GRIAC Research Institute Groningen the Netherlands 3 Certe integral medical diagnostic services and advice Groningen Question Answer options *=more than 1 answer option was allowed Which word(s) best describe(s) your opinion on this information?* Useful 46% Pleasant 18% Nice 6% Interesting 36% Frightening 0% Puzzling 3% Useless What are you planning to do with this information? Keep it 85% Throw away Not sure Show it to others Would you like to view your own medical records again in the future? Yes 97% No Which formats would you like to view in the future? Format 1 Format 1+2 12% All formats 82% None Do you think this information will help you cope with your respiratory symptoms? Definitely 30% Probably Maybe 21% Probably not Definitely not Table 1: the 3 formats of personal medical results that were provided to all patients. Below, the average score of patients for the different formats. Patients could rate each format on a scale from 1 (very poor) to 10 (excellent). 6% of the patients gave a mark below 6 (unsatisfactory ). Scan the QR code! Figure 1: overview of the Asthma/COPD –service assessment procedure in this study Figure 2: picture of the results of an assessment from one of our patients Table 2: evaluation of patients'’ opinions about the provided information (n total =33) GRONINGEN RESEARCH INSTITUTE FOR ASTHMA AND COPD Table 1: This table presents a comparison of individual patient diagnoses given by the pulmonologists and diagnoses predicted with the decision tree.   Diagnosis predicted by decision support tool ACOS* n COPD Asthma Other** Total n (%) Correct AC service Certe Groningen 225 355 98 33 711 (7.6) 225 (31.6) 135 1454 68 59 1716 (18.5) 1454 (84.7) 162 101 3253 609 4125 (44.4) 3252 (78.9) 28 128 1109 1480 2745 (29.5) 1480 (53.9) Total n (%) 550 (5.9) 2038 (21.9) 3419 (48.7) 2181 (23.5) 9297 (100) 6412 (69.0) AC serviceSTAR Rotterdam 152 35 2 247 (7.9) 59 (23.9) 53 452 36 6 555 (17.7) 452 (82.7) 42 32 532 78 685 (21.8) 532 (77.8) Probable asthma 11 7 580 238 836 (26.6) 580 (69.4) 21 72 919 651 818 (26.0) 651 (50.5) 175 (5.6) 708 (22.5) 1522 (48.5) 737 (23.5) 3141 (100.0) 2044 (65.1) * Asthma/COPD overlap syndrome, ** “Diagnosis unclear”, “indication of restriction” or “no disease”