A video-simulation study of the management of asthma exacerbations by physicians in India.

Introduction: Despite efforts to improve the management of asthma worldwide, few options exist for evaluating the specific needs or the success of these activities in a manner free from bias. Objectives: To examine the management of asthma exacerbations by physicians using standardized audiovisual presentations of asthma. Methods: Practitioners ( n = 70) in Chennai, India were shown the International Study of Asthma and Allergies in Childhood video questionnaire and asked to describe the clinical investigations, emergency treatments and prescription therapy they would recommend for each of the five scenes. Results: Practitioners varied significantly in their investigation and treatment of the exacerbations. Those who identified asthma as a possible cause of the scenes were more likely to recommend investigations and treatment congruent with international guidelines, as were those with additional postgraduate training and with specialty training in respiratory disease. Approaches differed significantly for scenes depicting wheeze compared with those depicting cough. Conclusion: The management of asthma exacerbations varies significantly depending on whether practitioners identify asthma as a possible cause of the presentation. Standardized audiovisual depictions of asthma offer a useful tool to assess patterns of clinical practice, and to design and evaluate activities to raise the quality of care for asthma. Please cite this paper as: Van Sickle D and Singh RB. A video-simulation study of the management of asthma exacerbations by physicians in India. The Clinical Respiratory Journal 2008; 2: 98–105. [ABSTRACT FROM AUTHOR]