Diagnosing asthma in young children

Current Opinion in Allergy and Clinical Immunology

Volumn 6, Issue 2, 2006, Pages 101-105

  Amado, Mercedes C ^a   Portnoy, Jay M ^a  

^a CHILDREN S MERCY HOSPITAL   (United States)

Author keywords

Asthma diagnosis; Likelihood ratio

Indexed keywords

ASTHMA; BRONCHUS HYPERREACTIVITY; CAREGIVER; CHILD; CHRONIC INFLAMMATION; CORRELATIONAL STUDY; DIAGNOSTIC ACCURACY; DIAGNOSTIC PROCEDURE; DIAGNOSTIC TEST; EVIDENCE BASED MEDICINE; HEALTH EDUCATION; HUMAN; LUNG FUNCTION TEST; MORTALITY; PATHOPHYSIOLOGY; PATIENT CARE; PRIORITY JOURNAL; PROGNOSIS; RESPIRATORY TRACT INFLAMMATION; REVIEW; SENSITIVITY AND SPECIFICITY; SYMPTOM; TREATMENT PLANNING; FEMALE; INFANT; MALE; PRESCHOOL CHILD;

ASTHMA; CHILD, PRESCHOOL; FEMALE; HUMANS; INFANT; MALE; PROGNOSIS; RESPIRATORY FUNCTION TESTS;

EID: 33746795522     PISSN: 15284050     EISSN: 14736322     Source Type: Journal    
DOI: 10.1097/01.all.0000216852.18194.0f     Document Type: Review

References (21)

1. NAEPP. Expert Panel Report 2: clinical practice guidelines. Guidelines for the diagnosis and management of asthma. Rockville, MD: US Department of Health and Human Services, Public Health Service, National Heart, Lung, and Blood Institute; 1997. NIH Publ. No. 98-4051.
2. Akinbami LJ, Schoendorf KC. Trends in childhood asthma: prevalence, health care utilization, and mortality. Pediatrics 2002; 110 (Pt 1):315-322.
3. Mannino DM, Homa DM, Akinbami LJ, et al. Surveillance for asthma: United States, 1980-1999. MMWR Surveill Summ 2002; 51:1-13.
4. McNicol KN, Macnicol KN, Williams HB. Spectrum of asthma in children. I: Clinical and physiological components. BMJ 1973; 4:7-11.
5. van Schayck CP, van der Heijden FMMA, van den Boom G, et al. Under-diagnosis of asthma: is the doctor or the patient to blame? The DIMCA project. Thorax 2000; 55:562-565.
6. Clark CE, Coote JM, Silver DAT, Halpin DMG. Asthma after childhood pneumonia: six year follow up study. BMJ 2000; 320:1514-1516.
7. Martinez F, Wright A, Taussig L, et al. Asthma and wheezing in the first six years of life. N Engl J Med 1995; 332:133-138.
8. Martinez FD. Present and future treatment of asthma in infants and young children. J Allergy Clin Immunol 1999; 104 (Pt 2):169-174.
9. Sackett D, Straus S, Richardson W, et al. Diagnosis and screening. In: Evidence-based medicine: how to practice, teach, EB.M., 2nd ed., New York, NY: Churchill Livingstone, 2000., 67-94.
10. Adams CD, Dreyer ML, Dinakar C, Portnoy JM. Pediatric asthma: a look at adherence from the patient and family perspective. Curr Allergy Asthma Rep 2004; 4:425-432. This review takes a look at the issues of treatment adherence and compliance from the patient's perspective. Patients choose their treatment based on a variety of inputs, only part of which include what their doctor recommends. When they choose not to follow the treatment plan, it may not be due to lack of understanding or ignorance but rather an intentional decision on the patient's part.
11. Portnoy JM. Evidence-based strategies for evaluating allergic rhinitis. Curr Allergy Asthma Rep 2004; 4:423. This review describes how to use evidence-based medicine to make clinical decisions using likelihood ratios and treatment thresholds with rhinitis as an illustrative disease.
12. Peat JK, Toelle BG, Mellis CM. Problems and possibilities in understanding the natural history of asthma. J Allergy Clin Immunol 2000; 106 (Suppl):S144-S152.
13. Henriksen AH, Holmen TL, Bjermer L. Gender differences in asthma prevalence may depend on how asthma is defined. Respir Med 2003; 97:491-497.
14. Dundas I, Chan EY, Bridge PD, McKenzie SA. Diagnostic accuracy of bronchodilator responsiveness in wheezy children. Thorax 2005; 60:13-16. Though the response that a child has to a bronchodilator is often considered to be 'diagnostic' of asthma, it actually is a diagnostic test and has to be understood as such. A full understanding of how diagnostic tests help clinicians make decisions is important.
15. Beydon N, Pin I, Matran R, et al. Pulmonary function tests in preschool children with asthma. Am J Respir Crit Care Med 2003; 168:640-644.
16. Pekkanen J, Sunyer J, Anto JM, Burney P. Operational definitions of asthma in studies on its aetiology. Eur Respir J 2005; 26:28-35. This article discusses the difficulties involved in defining asthma and how different purposes will drive which diagnostic criteria are to be used.
17. De Baets F, Bodart E, Dramaix-Wilmet M, et al. Exercise-induced respiratory symptoms are poor predictors of bronchoconstriction. Pediatr Pulmonol 2005; 39:301-305.
18. Schonberger H, van Schayck O, Muris J, et al. Towards improving the accuracy of diagnosing asthma in early childhood. Eur J Gen Pract 2004; 10:138-145; 151.
19. Galant SP, Crawford LJ, Morphew T, et al. Predictive value of a cross-cultural asthma case-detection tool in an elementary school population. Pediatrics 2004; 114:e307-e316.
20. Gerald LB, Grad R, Turner-Henson A, et al. Validation of a multistage asthma case-detection procedure for elementary school children. Pediatrics 2004; 114:e459-e468.
21. Bent S, Friedland D. Treatment and testing thresholds. In: Friedland D, Go A, Davoren J, et al., editors. Evidence-based medicine: a framework for clinical practice. Stamford, CT: Appleton and Lange; 1998. pp. 59-83.