Related Experiment Video
Updated: Mar 25, 2026
Bronchial Thermoplasty: A Novel Therapeutic Approach to Severe Asthma
Published on: November 4, 2010
Overdiagnosis of asthma in children in primary care: a retrospective analysis
Ingrid Looijmans-van den Akker1, Karen van Luijn1, Theo Verheij2
1Leidsche Rijn Julius Health Care Centers, Utrecht, the Netherlands.
Insights
Childhood asthma overdiagnosis is common in primary care, with over half of diagnoses unlikely based on symptoms. Confirming asthma with lung function tests is rare, leading to unnecessary treatment and burden.
Area of Science:
- Pediatric respiratory medicine
- Primary healthcare research
- Diagnostic accuracy studies
Background:
- Asthma is a prevalent chronic childhood illness.
- Current guidelines recommend lung function testing for asthma diagnosis in children over 6 years old.
- Previous research suggests potential overdiagnosis of childhood asthma, but the extent remains unquantified.
Purpose of the Study:
- To determine the prevalence and characteristics of confirmed and unconfirmed asthma diagnoses in children.
- To evaluate the diagnostic practices for childhood asthma in primary care settings.
Main Methods:
- Retrospective analysis of routine care registration data from four academic primary healthcare centers in the Netherlands.
- Inclusion criteria: children aged 6-18 years with an asthma diagnosis or treated for asthma.
Main Results:
- Spirometry confirmed asthma in only 16.1% of diagnosed children.
- Over half (53.5%) of children with an asthma diagnosis were likely overdiagnosed, as symptoms made asthma unlikely.
- Dyspnea, cough, and wheezing were primary reasons for unconfirmed asthma diagnoses without further lung function testing.
Conclusions:
- Overdiagnosis of childhood asthma is frequent in primary care, resulting in unnecessary treatments and reduced quality of life.
- Confirmation of asthma diagnoses through lung function testing is infrequent in this pediatric population.
- Improved diagnostic strategies are needed to reduce overdiagnosis and ensure appropriate asthma management in children.
Background:
Asthma is one of the most common chronic diseases in childhood. According to guidelines, a diagnosis of asthma should be confirmed using lung function testing in children aged >6 years. Previous studies indicate that asthma in children is probably overdiagnosed. However, the extent has not previously been assessed.
Aim:
To assess the extent and characteristics of confirmed and unconfirmed diagnoses of asthma in children who were diagnosed by their GP as having asthma or who were treated as having asthma.
Design And Setting:
Retrospective analysis in four academic primary healthcare centres in Utrecht, the Netherlands.
Method:
Routine care registration data of children aged 6-18 years who received a diagnosis of asthma or were treated as having asthma were analysed.
Results:
In only 16.1% (n = 105) of the children diagnosed with asthma was the diagnosis confirmed with spirometry, whereas in 23.2% (n = 151) the signs and symptoms did give rise to suspected asthma but the children should have undergone further lung function tests. In more one-half (53.5%, n = 349) of the children the signs and symptoms made asthma unlikely and thus they were most likely overdiagnosed. The remaining 7.2% (n = 47) were probably correctly classified as not having asthma. The main reasons for classifying asthma without children undergoing further lung function tests were dyspnoea (31.9%, n = 174), cough (26.0%, n = 142), and wheezing (10.4%, n = 57).
Conclusion:
Overdiagnosis of childhood asthma is common in primary care, leading to unnecessary treatment, disease burden, and impact on quality of life. However, only in a small percentage of children is a diagnosis of asthma confirmed by lung function tests.
Related Concept Videos
01:30Asthma-IV: Diagnostic and Management
Clinical Assessment for Asthma:
This is the first step in diagnosing and managing asthma. It includes:
01:29Asthma-I: Introduction
01:24Asthma-III: Symptoms and Complications
Classification of Asthma
01:26Asthma-II: Pathophysiology and Classification
Additionally, environmental and genetic factors play crucial roles in determining an individual's susceptibility to asthma and the severity of their condition.
Critical processes in asthma pathophysiology include:
01:20Asthma: Pathogenesis and Management
Asthma is classified as allergic and non-allergic. Allergens such as dust mites, pollen, and pet dander trigger allergic asthma, while factors like cold air, intense emotions, or exercise can induce non-allergic asthma.
01:30Asthma-IV: Nursing Management
First, in...