Although international guidelines uniformly recommend objective testing to establish an asthma diagnosis, this diagnosis is often made clinically and asthma medications are often initiated on that clinical basis. However, physical exam findings and symptoms such as cough, wheeze, and/or dyspnea can be caused by other conditions. As a result, up to one third of patients who have been diagnosed with asthma do not have evidence of asthma when objectively tested with pulmonary function tests. A false clinical diagnosis of asthma may delay diagnosis of the actual underlying condition, which may include serious cardiorespiratory conditions. Furthermore, patients with a false diagnosis of asthma who are started on asthma medications are unnecessarily exposed to both the side-effects and the costs of these medications. It should be noted, however, that this recommendation may not be applicable in patients who cannot reproducibly undergo objective testing for asthma (including children less than 6 years old), and in settings where such testing is not available.
Conditions: Asthma
Diagnostic Tests: Spirometry, methacholine or exercise challenge test
Treatments: Inhalers, leukotriene receptor antagonists
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