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Timeliness of diagnosis of asthma in children and its predictors
W E Molis1, S Bagniewski, A L Weaver
1Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN 55905, USA.
Insights
Many children with asthma face delayed diagnoses, particularly those lacking typical risk factors. Early recognition and diagnosis are crucial for effective asthma management in pediatric populations.
Area of Science:
- Pediatric Pulmonology
- Respiratory Medicine
- Clinical Epidemiology
Background:
- Limited research exists on the timeliness of pediatric asthma diagnosis using medical records.
- Identifying predictors for timely asthma diagnosis in children is an under-explored area.
Purpose of the Study:
- To evaluate the timeliness of asthma diagnosis in children.
- To identify predictors associated with timely asthma diagnosis.
Main Methods:
- Retrospective review of medical records for 839 children aged 5-13 years.
- Asthma status determined using predefined criteria.
- Analysis of predictors for timely asthma diagnosis.
Main Results:
- 276 of 839 children met asthma criteria before age 18.
- 97 children received timely diagnosis; 179 experienced a median delay of 3.3 years.
- Definite asthma (HR 3.3), family history (HR 1.36), and exercise-induced wheezing (HR 1.79) were associated with more timely diagnosis.
Conclusions:
- A significant number of children with asthma are diagnosed late.
- Children without common asthma indicators may face diagnostic delays.
- Healthcare providers and asthma guidelines should address diagnosis in atypical cases.
Background:
There is a paucity of literature using medical records to evaluate the timeliness of asthma diagnosis in children and the predictors associated with timeliness of asthma diagnosis.
Methods:
Subjects were obtained from a convenience sample of 839 children, aged 5-13 years. We conducted comprehensive medical record reviews for these children to determine their asthma status by applying predetermined criteria for asthma. Predictors were evaluated for an association with timeliness of asthma diagnosis.
Results:
Of 839 children, 276 children met the criteria for asthma before 18 years of age. Of these subjects, 97 had timely diagnosis of asthma while 179 did not have timely diagnosis of asthma with the median delay of 3.3 years. Children with definite asthma at the time of index date was three times more timely to be diagnosed with asthma [hazard ratios (HR) 3.3, 95% CI: 2.43-4.47, P < 0.001], compared to those with probable asthma. Children with a family history of asthma were more timely to be diagnosed with asthma (HR 1.36, 95% CI: 1.03-1.8, P = 0.031). Children with exercise-induced wheezing or bronchospasm were more timely to be diagnosed with asthma (HR 1.79, 95% CI: 0.95-3.36, P = 0.07), compared to those with spasmodic (or bronchospastic) cough.
Conclusions:
Many asthmatic children are not diagnosed with asthma in a timely manner, especially in those without the commonly recognized factors associated with asthma. Health care providers need to be reminded that asthma can still occur in those without commonly recognized risk factors. Asthma guidelines need to emphasize this aspect.
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