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Active approach to recognising asthma in general practice.

British Medical Journal (Clinical Research Ed.)

|June 1, 1985

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A study of children born in 1977 found 8% diagnosed with asthma. Further analysis revealed 6% had exercise-induced asthma and 3% showed clinically significant airway obstruction, highlighting the need for active diagnosis.

Area of Science:

Pediatrics
Respiratory Medicine
General Practice

Background:

Asthma diagnosis in children can be challenging in general practice settings.
Underdiagnosis of pediatric asthma may lead to delayed treatment and poorer outcomes.

Purpose of the Study:

To investigate the prevalence of diagnosed and undiagnosed asthma in a cohort of children.
To evaluate the utility of exercise testing and specific symptoms in identifying pediatric asthma.

Main Methods:

Retrospective review of general practice medical records for 214 children born in 1977.
Exercise testing was performed on children suspected of having undiagnosed asthma based on a scoring system.
Analysis of symptom combinations (atopic eczema, cough, wheezing) for predictive value.

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Main Results:

A diagnosis of asthma was recorded in 8% (18/214) of the children.
Exercise testing identified exercise-induced asthma in 6% (12/214) of the cohort.
An additional 3% (7/214) had symptoms and borderline exercise tests indicating significant airway obstruction.
Combinations of atopic eczema, nocturnal cough, persistent cough, and wheezing predicted asthma in over 50% of cases.

Conclusions:

A significant proportion of pediatric asthma cases may remain undiagnosed in general practice.
Active case-finding using exercise testing and symptom analysis is necessary and feasible.
Improved diagnostic strategies can enhance the timely identification and management of childhood asthma.