4Q Model: How to Apply Guidelines for COPD in Primary Care

Carla Bruschelli, Germano Bettoncelli, Giorgio Carlo Monti

DOI: https://doi.org/10.7175/cmi.v12i1.1335


According to Italian General Practitioners (GPs), it is difficult to use guidelines and consensus, because they refer mainly to the disease and they are not close to the variability of real life.

To help GPs perform clinical audits and address some management problems, we have devised a new analysis methodology: four-quadrant (4Q) diagnostic analysis.

4Q model describes, in a fairly realistic way, the characteristics and clinical issues of patients with chronic obstructive pulmonary disease (COPD) during visits in the General Medicine setting. Using this model, GPs can identify and group patients in four specific areas; depending on the membership, the intervention is defined by the guidelines and the evidence-based medicine.


Management; General Practitioners; Guidelines; Four-Quadrant Model

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