Abstract
Rationale: In primary care settings the clinical diagnosis of paediatric asthma is mainly based on symptoms.
Objective: To assess diagnostic outcome in schoolchildren referred to a secondary paediatric referral centre with a suspected or established primary care doctor's diagnosis of bronchial asthma.
Methods: Children with a suspected or established primary care doctor's diagnosis of bronchial asthma were included in the survey. At referral and during a 6 months evaluation period patient characteristics, history, symptoms, signs and results of type 1 allergy tests, spirometry, post bronchial beta-2 agonist dilation tests, 4-weeks daily measurement of peak flow rates, corticosteroid reversibility trials and exercise challenge tests were entered into a pre-defined electronic form. The secondary centre diagnosis of asthma was based on these data.
Results: 665 consecutively referred children aged 5-15 (mean 8.1) years, 233 girls (35%) and 432 boys (65%), were included in the study. 183 (27.5%) children had a referral diagnosis of suspected asthma, 482 (72.5%) an established referral diagnosis of asthma. In the latter group 316 children (65.5%) were on inhaled steroids at the time of referral, 166 ((34.5%) were not. In the groups of suspected and established asthma the diagnosis was confirmed in 82 (44.8%) and 200 (41.5%), respectively.
Conclusions: In more than half of schoolchildren with a suspected or established primary care doctor's diagnosis of asthma referred to a secondary paediatric referral centre the diagnosis may not be confirmed. Sensitivity and specificity of the diagnosis of asthma in schoolchildren established in primary care settings need further improvement.
- © 2011 ERS
