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Pulmonary function testing in the diagnosis of asthma: a population study
Andrea S Gershon1, J Charles Victor2, Jun Guan3
1Institute for Clinical Evaluative Sciences, Toronto; The Hospital For Sick Children, Toronto; Sunnybrook Health Sciences Centre, Toronto; Department of Medicine, Toronto; University of Toronto, Toronto.
Chest
|October 28, 2011
Summary
Less than half of Ontarians diagnosed with asthma received pulmonary function testing. Age, income, and physician type influenced testing rates, highlighting a need to improve diagnostic practices for asthma.
Area of Science:
- Respiratory Medicine
- Public Health
- Health Services Research
Background:
- Asthma diagnosis relies on symptoms and objective evidence of airflow obstruction or hyperresponsiveness.
- Understanding the utilization of pulmonary function testing (PFT) at asthma diagnosis is limited.
Purpose of the Study:
- To determine the proportion of individuals with new asthma diagnoses who received PFT around the time of diagnosis.
- To identify patient and clinical factors associated with PFT receipt in newly diagnosed asthma patients.
Main Methods:
- Retrospective cohort study utilizing health administrative data from Ontario, Canada (1996-2007).
- Inclusion criteria: individuals aged 7+ with newly physician-diagnosed asthma.
- Analysis of PFT receipt in the peridiagnostic period (1 year prior to 2.5 years post-diagnosis) across sociodemographic and clinical factors.
Main Results:
- Only 42.7% of 465,866 newly diagnosed asthma patients received PFT.
- Younger (7-9 years) and older (70+ years) age groups were less likely to receive PFT.
- Lower neighborhood income quintiles and general practitioner care were associated with reduced PFT rates.
Conclusions:
- A significant proportion of asthma diagnoses in Ontario lack objective PFT confirmation.
- Further research is required to understand barriers to PFT use and improve asthma diagnostic strategies.
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