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Rebuttal From Dr CelliRebuttal From Dr Celli

Bartolome R. Celli, MD, FCCP
Author and Funding Information

From the Pulmonary and Critical Care Medicine Division, Brigham and Women’s Hospital; and Department of Medicine, Harvard Medical School.

Correspondence to: Bartolome R. Celli, MD, FCCP, Pulmonary and Critical Care Medicine Division, Brigham and Women’s Hospital, 75 Francis St, Boston, MA 02115; e-mail: bcelli@partners.org


Financial/nonfinancial disclosures: The author has reported to CHEST the following conflicts of interest: Dr Celli has participated in advisory boards for GlaxoSmithKline; Boehringer Ingelheim GmbH; Almirall, S.A.; AstraZeneca; Aeris; Deep Breeze Ltd; Takeda Pharmaceutical Company Limited; and Novartis Corp. The Pulmonary Division where Dr Celli is employed has received funds for research studies from GlaxoSmithKline; Boehringer Ingelheim GmbH; Forrest Medical, LLC; AstraZeneca; and Aeris. Dr Celli and his family do not have shares or interest in any company, and Dr Celli has not received tobacco money or stocks in any tobacco-related companies.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2014;145(6):1195-1196. doi:10.1378/chest.13-2863
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Extract

A click on the first reference provided by the proponents of storefront clinics (SFCs) for COPD case finding and chronic care1 takes us to one-stop care for everything: from an appointment for a perfect haircut to obtaining a walker.2 The site is extensive in proposed services but limited in details. I was unable to obtain any objective evaluation of the quality and proven outcomes of health-care delivery in diabetes, hypertension, gastroesophageal reflux disease, and ostheoarthritis as mentioned by Drs Enright and Nevin.1 As I have documented in the opening statements of my argument, the adequate performance and interpretation of spirometry, even in the best centers, remains a problem.3 We, the supposed experts, do not even agree on the correct diagnosis of obstruction in a valid spirometry test. Is it the fixed ratio or the lower limit of normal?4-6 How are we to direct others in this endeavor? Extending these problems to SFCs without previous efforts to improve the existing gaps may actually worsen rather than help the current efforts to have an impact on the COPD epidemic.

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