Late Breaking Abstract - Improving the diagnosis of breathlessness in primary care: development and implementation of the “Breathlessness Diagnostics in a Box” (BiaB)

Breathlessness is a common reason for consulting a general practitioner and can have different causes including pulmonary and cardiovascular conditions. There is a lack of easy-to-perform tests in primary care to diagnose the cause. In this pilot study, we design and test “Breathlessness Diagnostics in a Box” (BiaB), an easy and quick tool which aims to support general practitioners in diagnosing the cause of breathlessness Healthcare professionals and clinical experts in the fields of pulmonology, cardiology and primary care co-design the tool. The current version of the BiaB box includes an oscillometer; a 4-patch 12-lead ECG; a point-of-care NT-proBNP test (≥450 pg/mL), a pulse oximeter and an iPad with an application+algorithm integrating test results into a working diagnosis. Potential outcomes: heart failure (HF), pulmonary obstruction or restriction, or a combination of pulmonary and cardiac. Patients with breathlessness of unknown cause, or at risk of HF or COPD are eligible for inclusion. Time for performing BiaB, time to diagnosis/referral are pre-defined outcomes To date, 57 subjects were assessed. Time to use BiaB is 15-20 minutes. Oscillometry showed 11 (19.7%) obstructive and 7 (12.3%) restrictive patterns. Two of the 55 (3.5%) NT-proBNP tests were positive. ECGs showed inconclusive results in 45 (78.9%) cases Running the BiaB in primary care is feasible and fast. The interpretation of the initial tests requires further adaptation of the algorithms. After 120 inclusions, we will report on the number of referrals, confirmed diagnoses, time between consultation and diagnosis, and number of new diagnoses of COPD, HF and their overlap