Although asthma is very common affecting 5–10% of the population, the diagnosis of asthma in adults remains a challenge in the real world that results in both over-and under-diagnosis. A task force (TF) was set up by the European Respiratory Society to systematically review the literature on the diagnostic accuracy of tests used to diagnose asthma in adult patients and provide recommendations for clinical practice.
The TF supports the initial use of spirometry followed, and if airway obstruction is present, by bronchodilator reversibility testing. If initial spirometry fails to show obstruction, further tests should be performed in the following order: FeNO, PEF variability or in secondary care, bronchial challenge. We present the thresholds for each test that are compatible with a diagnosis of asthma in the presence of current symptoms.
The TF reinforces the priority to undertake spirometry and recognises the value of measuring blood eosinophils and serum IgE to phenotype the patient. Measuring gas trapping by body plethysmography in patients with preserved FEV1/FVC ratio deserves further attention. The TF draws attention on the difficulty of making a correct diagnosis in patients already receiving inhaled corticosteroids, the comorbidities that may obscure the diagnosis, the importance of phenotyping, and the necessity to consider the patient’s experience in the diagnostic process.
Expert interview. Programme as follows:
- Why to set up ERS guidelines? – Professor Omar Usmani [5 minutes]
- Overview of the guidelines – Professor Renaud Louis [20 minutes]
- Clinical cases of asthma diagnosis – Dr Imran Satia [20 minutes]
- Q&A – [15 minutes]
Discuss the diagnostic accuracy of tests used to diagnose asthma in adult patients
Recognise the complexities of diagnosing asthma in patients
An application for accreditation of this webinar has been made to the European Board for Accreditation in Pneumology (EBAP) for 1 CME credit per 1-hour attendance. If accredited, the CME credit will be granted upon attendance of at least 60 minutes during the live webinar only.
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Diseases / methods
- Airway diseases