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Lack of definitive asthma test leads to over-diagnosis

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A more precise test for asthma is needed A more precise test for asthma is needed to prevent over-diagnosis

Respiratory nurses and clinicians have expressed concern that the lack of a definitive test for asthma is leading to high rates of over-diagnosis.

A BMJ editorial by two leading respiratory doctors argued that ‘inhalers are frequently dispensed for no good reason’ and have almost become a ‘fashion accessory’ and that children with asthma-like symptoms should be given proper diagnostic tests.

Sue Frost, lead respiratory nurse at Birmingham Children’s Hospital and chair of National Paediatric Respiratory and Allergy Nurses Group, responded that asthma should only be diagnosed after objective evidence has been gained.

‘In school-age children this evidence may be considered from a detailed medical history, symptom diary and home peak flow diary. Peak flow recordings over a period of two to three weeks are often a useful measurement, especially if the professional has no access to other lung function testing equipment.’

Ms Frost says a trial of asthma therapy could be considerered and monitored by the health professional. ‘If there is no proven benefit. In this situation, a referral to secondary care should be considered to exclude alternative diagnosis’.

Asthma UK agreed that ‘there currently isn’t one definitive way of easily diagnosing asthma’.

‘It’s astonishing in the 21st century that there isn’t a test your child can take to tell if they definitely have asthma,’ said Dr Samantha Walker, director of research and policy at Asthma UK.

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