Confirmation of asthma in an era of overdiagnosis

被引:69
|
作者
Luks, V. P.
Vandemheen, K. L. [1 ]
Aaron, S. D. [1 ]
机构
[1] Univ Ottawa, Ottawa Hlth Res Inst, Ottawa, ON, Canada
基金
加拿大健康研究院;
关键词
Asthma; bronchial hyperreactivity; diagnosis; spirometry; BRONCHIAL HYPERRESPONSIVENESS; AIRWAY HYPERRESPONSIVENESS; CLINICAL ASTHMA; METHACHOLINE; RESPONSIVENESS; POPULATION; BUDESONIDE;
D O I
10.1183/09031936.00165109
中图分类号
R56 [呼吸系及胸部疾病];
学科分类号
摘要
It was recently shown that 30% of adults with a physician diagnosis of asthma did not have asthma when objectively assessed using a four-step algorithm involving serial spirometry, bronchial challenge testing and subsequent tapering of asthma medications. The objective of the present study was to determine how many steps in the algorithm were required in order to confirm asthma, and whether any patient-related variables were associated with earlier asthma confirmation. A total of 540 subjects with a previous physician diagnosis of asthma were randomly recruited from the community. The number of subjects confirmed with asthma at each study visit was calculated. Regression analysis was used to determine variables associated with earlier asthma confirmation. Of the 499 subjects who completed the diagnostic algorithm, 346 (69%) had asthma confirmed and 150 (30%) had asthma excluded. Of subjects in whom asthma was confirmed, including those using regular asthma controlling medications, >90% were confirmed with only one or two study visits, by either pre- and post-bronchodilator spirometry or a single bronchial challenge test. Only 46 (9%) out of 499 subjects required tapering of asthma medications and repeated bronchial challenge tests for exclusion or confirmation of asthma. Lower forced expiratory volume in 1 s and younger age were associated with earlier asthma confirmation. For the majority with a previous physician diagnosis of asthma, only pre- and post-bronchodilator spirometry and a single methacholine challenge test are required in order to confirm asthma.
引用
收藏
页码:255 / 260
页数:6
相关论文
共 50 条
  • [21] Overdiagnosis of asthma in obese and nonobese adults (vol 179, pg 1121, 2008)
    Purohit, Nimisha
    CANADIAN MEDICAL ASSOCIATION JOURNAL, 2008, 179 (12) : 1301 - 1301
  • [22] Objective confirmation of asthma diagnosis improves medication adherence
    Backer, V.
    Stensen, L.
    Sverrild, A.
    Wedge, E.
    Porsbjerg, C.
    JOURNAL OF ASTHMA, 2018, 55 (11) : 1262 - 1268
  • [23] The challenge of objective confirmation of asthma diagnosis in primary care
    Kaicker, Jatin
    Dang, Wilfred
    D'Urzo, Anthony
    NPJ PRIMARY CARE RESPIRATORY MEDICINE, 2014, 24
  • [24] The challenge of objective confirmation of asthma diagnosis in primary care
    Jatin Kaicker
    Wilfred Dang
    Anthony D’Urzo
    npj Primary Care Respiratory Medicine, 24
  • [25] Differentiating asthma and tracheal stenosis: why confirmation of the diagnosis of asthma should precede treatment
    Kazi, Ananna
    Shidid, Sarah
    Gutierrez, Anna Katrina
    Ferastraoaru, Denisa
    JOURNAL OF ASTHMA, 2025, 62 (04) : 737 - 740
  • [26] Choosing wisely in the era of biologics for asthma
    Lougheed, M. Diane
    ANNALS OF ALLERGY ASTHMA & IMMUNOLOGY, 2018, 120 (04) : 345 - 346
  • [27] Asthma Phenotypes in the Era of Personalized Medicine
    Gonzalez-Uribe, Victor
    Romero-Tapia, Sergio J.
    Castro-Rodriguez, Jose A.
    JOURNAL OF CLINICAL MEDICINE, 2023, 12 (19)
  • [28] Allergic Asthma in the Era of Personalized Medicine
    Papapostolou, Niki
    Makris, Michael
    JOURNAL OF PERSONALIZED MEDICINE, 2022, 12 (07):
  • [29] Asthma in the era of COVID-19
    Assaf, Sara
    Stenberg, Henning
    Jesenak, Milos
    Tarasevych, Svitlana P.
    Hanania, Nicola A.
    Diamant, Zuzana
    RESPIRATORY MEDICINE, 2023, 218
  • [30] Managing asthma in the era of biological therapies
    Bardin, Philip G.
    Price, David
    Chanez, Pascal
    Humbert, Marc
    Bourdin, Arnaud
    LANCET RESPIRATORY MEDICINE, 2017, 5 (05): : 376 - 378