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Table 4 Process involving the GP

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

1a. The patient visits the GP because, through a health information campaign and also by means of a questionnaire, they have become aware of their own respiratory symptoms.
  Or:
1b. The patient goes to the GP for reasons other than the presence of respiratory symptoms, and it is the doctor who seeks for the presence of respiratory symptoms and traces the patient’s risk profile.
2. The doctor confirms or disconfirms the clinical suspicion of COPD.
3. In the affirmative, he will get the patient to perform a spirometry test.
4. If the spirometry shows an impairment, it requires confirmation through a global spirometry or a specialist referral.
  Nonetheless, people who result negative on the simple spirometry test but in the opinion of the GP are still suspect of chronic respiratory disease should be referred for further respiratory function tests, since simple spirometry is a test of low sensitivity.