RT Journal Article
SR Electronic
T1 Over- and under-diagnosis in asthma
JF Breathe
JO Breathe
FD European Respiratory Society
SP e20
OP e27
DO 10.1183/20734735.0362-2018
VO 15
IS 1
A1 Kavanagh, Joanne
A1 Jackson, David J.
A1 Kent, Brian D.
YR 2019
UL http://breathe.ersjournals.com/content/15/1/e20.abstract
AB Asthma is extremely common with a prevalence of approximately 10% in Europe. It presents with symptoms which have a broad differential diagnosis and examination can be entirely normal. There is no agreed gold standard to diagnose asthma, and the objective tests that can aid diagnosis are often poorly available to primary care physicians. There is evidence that asthma is widely misdiagnosed. Overdiagnosis leads to unnecessary treatment and a delay in making an alternative diagnosis. Underdiagnosis risks daily symptoms, (potentially serious) exacerbations and long-term airway remodelling. An agreed standardised approach to diagnosis, with inclusion of objective measurements prior to treatment, is required to reduce misdiagnosis of asthma.Key pointsAsthma presents with common respiratory symptoms and physical examination is often normal; in addition, the most widely available tests (peak flow and spirometry) can be normal unless the patient is exacerbating.Treating asthma prior to carrying out objective tests decreases their sensitivity and can make confirmation of the diagnosis difficult.There is no single gold standard test to diagnose asthma, and there are significant differences between the suggested algorithms in commonly used guidelines.Both under- and over-diagnosis are widespread and lead to significant risks to patients.Asthma is frequently misdiagnosed. Both over- and under-diagnosis are associated with inappropriate treatment and potential patient harm. Although no gold standard diagnostic test is available, objective testing can improve diagnostic accuracy. http://ow.ly/Ej3830ohfxJ