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Problems Over Diagnosis of Asthma

It has been reported recently that more than 1million people receiving treatment for asthma may have been misdiagnosed. Asthma is one of the world’s most common chronic diseases in childhood, affecting 1.1million children (one in 11) and 4.3m million adults (one in 12) in the UK. Three people die every day because of asthma. Most of these deaths could have been avoided through better control of the disease, says Asthma UK.

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The National Institute for Health and Care Excellence (NICE) said studies showed that up to 30% of the 4.1million people treated for asthma in the UK did not show any “clear evidence” of the incurable condition, and may be receiving unnecessary treatment.

Accurate Diagnosis a Significant Problem

It is reported that accurate diagnosis of asthma has been a significant problem, which means people may be wrongly diagnosed, or cases might be missed in others. Some may have had asthma in the past, but many have probably been given an incorrect diagnosis, says NICE, which has drafted new advice for doctors. This is the first time NICE has published guidelines for asthma, for doctors in England to improve the accuracy of diagnoses, including an array of tests.

NICE guidelines for England, which are now out for consultation before final approval, say doctors should use more clinical tests to back up their judgement, and avoid the danger of wrongly labelling someone as having asthma. Over-treatment is a concern because some of the drugs used to manage asthma can have significant side-effects.

No Absolute Test

Diagnosis however can be difficult as there is no absolute test and Doctors often rely on their own expertise and the patient's symptoms to reach a diagnosis. NICE says doctors should use clinical tests to back up their diagnoses.

The aim with the NICE guideline is to give clarity and set out the most clinical and cost-effective ways to diagnose and monitor asthma based on the best available evidence. It will also provide advice for primary, secondary and community care healthcare professionals on the most suitable tests for accurately diagnosing asthma and how to help people monitor and control their symptoms.

Asthma UK welcomes the new guidelines - but warns there is also evidence that asthma is under-diagnosed too and that eight out of 10 asthma sufferers are still not getting the correct basic treatment.

No Gold Standard Test

NICE reports while there was no “gold standard test” available, with patients diagnosed based on a medical history, it recommended spirometry which is a machine which measures how much and how fast a person breathes out. This is the primary method for children over five and adults over 16 years. For children under five, doctors should monitor nitric oxide levels until they are old enough for clinical tests

Kay Boycott, Chief Executive at Asthma UK says: "Asthma has many complex causes which is one of the reasons why it is sometimes difficult to get a definitive diagnosis. For anyone with an asthma diagnosis, it is vital they have the right medication and a plan to better manage their condition and any asthma attacks."