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- W4243954719 abstract "The National Institute for Health and Care Excellence has opened consultation on draft guidelines entitled, “Asthma: diagnosis and monitoring of asthma in adults, children and young people”. Comments are invited by March 11 in anticipation of a July, 2015, publication. Around 4·1 million people receive asthma treatment in the UK and an estimated 235 million people have asthma worldwide. Diagnosis of asthma is not clear cut. It relies on clinical judgment of patient history, symptoms (breathing problems, wheezing, and coughing), and objective measures of airflow obstruction, using spirometry or peak flow, or of respiratory inflammation by measuring fractional exhaled nitric oxide (FeNO). However, no single diagnostic test, or set of tests, can definitively confirm asthma. According to the guidance, some estimates indicate that as many as 30% of people might have an asthma diagnosis without evidence of current clinical symptoms, underscoring the capacity for over-diagnosis and over-treatment. However, it is important to caution that the converse is also true—for many people, asthma can be under-recognised and undertreated. The guidelines attempt to offer a set of best practices and diagnostic pathways. Recommendations are stratified by age—under age 5, 5–16 years old, and adults and young people older than 16 years of age. The proposed algorithms include patient history, but also suggest the use of spirometry, bronchodilator reversibility, and FeNO, especially in patients older than 16 years, before making a diagnosis of asthma. However, the guidance acknowledges that such testing has only recently been introduced into primary care, equipment is patchy, and using spirometry in children 5–16 years of age “will be practically challenging”. Upon diagnosis, there is a welcome emphasis on asthma control—eg, improving adherence by reinforcing inhaler techniques and implementing telemonitoring. Asthma is a disorder with different phenotypes and different trajectories throughout life. It can be difficult to accurately diagnose and it is certainly difficult to control in some patients. An overly complex set of objective measures for diagnosis that are difficult to implement in primary care risks further undertreatment of this potentially lethal disease." @default.
- W4243954719 created "2022-05-12" @default.
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- W4243954719 date "2015-02-01" @default.
- W4243954719 modified "2023-09-30" @default.
- W4243954719 title "Asthma diagnosis and control" @default.
- W4243954719 doi "https://doi.org/10.1016/s0140-6736(15)60184-2" @default.
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