Poor perception of dyspnoea in children with undiagnosed asthma

¹ Máxima Medical Center, Dept of paediatrics, Veldhoven, The Netherlands
² Asthma Center Heideheuvel, Dept of paediatrics, Hilversum, The Netherlands
³ Julius Center for Health Sciences and Primary Care and Dept of paediatrics, University Medical Center Utrecht, Netherlands
⁴ Paediatric Infectious disease, University Medical Center Utrecht, The Netherlands
⁵ Institute for Risk Assessment Sciences (IRAS), Utrecht University Utrecht, The Netherlands; and Dept of Health Sciences, University Medical Center Groningen, University of Groningen, The Netherlands
⁶ Paediatric Pulmonology, University Medical Center Utrecht, The Netherlands

^* To whom correspondence should be addressed. E-mail: R.vanGent{at}mmc.nl.

	Abstract

The aim of our study was to establish differences in dyspnoea perception in children with undiagnosed asthma and diagnosed asthma.

A cross-sectional community-based study was performed including a parental questionnaire on their child's respiratory health, and testing of airway reversibility and bronchial hyperresponsiveness. "Diagnosed asthma" was defined by a physician's diagnosis of asthma. "Undiagnosed asthma" was defined by the presence of asthma symptoms combined with either airway reversibility or BHR without a physician's diagnosis of asthma. Only children with a positive bronchial hyperresponsiveness test were selected for further analysis. Perception of dyspnoea was assessed using the Borg scale and Visual Analogue Scale (VAS), plotted against the percent fall in FEV₁, and expressed as the slope of the regression line (Slope-Borg and Slope-VAS).

Of the initial 1758 children 70 children had undiagnosed asthma and 38 had diagnosed asthma. The Borg and VAS slopes in children with undiagnosed asthma were less steep than those of children with diagnosed asthma (Borg: 0.07 and 0.14, respectively; p=0.04; VAS: 0.06 and 0.11, respectively; p=0.11).

Among children with bronchial hyperresponsiveness, those without a parent's report of physician's diagnosis of asthma had a worse perception of dyspnoea than children with diagnosed asthma.