One in three asthma cases misdiagnosed

22 January 2017

One in three adults diagnosed with asthma may not actually have the chronic lung disorder.

A Canadian study has found 33 per cent of adults recently diagnosed with asthma did not have the condition, either because of doctor’s error or because they had overcome the problem.

Researchers from the University of Ottawa conducted a study involving over 700 adults who reported a history of physician-diagnosed asthma established within the past five years.

All participants were assessed with home peak flow and symptom monitoring and bronchial challenge tests, and those partakers using daily asthma medications had their medicines gradually lowered over four study visits. Participants in whom a diagnosis of current asthma was ultimately eliminated were checked up on clinically with repeated bronchial challenge tests over 12 months.

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Researchers ruled out asthma in 203 of the 613 patients who completed the study, which makes up 33.1 per cent of the entire sample. Of these, 12 study participants had other serious cardiorespiratory illnesses that might have been incorrectly diagnosed as asthma.

Additionally, 80 per cent of the misdiagnosed patients had been taking asthma medication, and 35 per cent of them had been doing so daily.

The researchers speculate that the failure to confirm the diagnosis could be because of “spontaneous remission” or misdiagnosis.

“At least 24 of 203 participants in whom current asthma was ruled out had undergone pulmonary function tests in the community that had been previously diagnostic of asthma. These participants presumably experienced spontaneous remission of their asthma at some time between their initial community diagnosis and entry into the study," the authors said.

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Asthma can be episodic or can follow a relapsing and remitting course, which further complicates attempts to arrive at a diagnosis based on a single patient-physician encounter.

Although asthma is a chronic disease, the expected rate of spontaneous remissions of adult asthma and the stability of diagnosis are unknown. The full study is published in JAMA.

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