Materiały źródłowe

• #1 Asthma in adolescents and adults: Evaluation and diagnosis – UpToDate

  https://www.uptodate.com/contents/asthma-in-adolescents-and-adults-evaluation-and-diagnosis

  Asthma in adolescents and adults: Evaluation and diagnosis […] The definitive diagnosis of asthma requires the history or presence of respiratory symptoms consistent with asthma, combined with the demonstration of variable expiratory airflow obstruction. […] Tools used in diagnosing asthma include history, physical examination, pulmonary function testing, and other laboratory evaluations. […] Ultimately, asthma is a clinical diagnosis that cannot be determined definitively by any single diagnostic test or result. […] Diagnosis based on history and clinical course. […] Initial spirometry shows airflow limitation. […] Initial spirometry is normal.

• #1 Asthma Diagnosis | AAFA.org

  https://aafa.org/asthma/asthma-diagnosis/

  To diagnose asthma, your doctor will talk to you about your personal and medical history. […] Your doctor will ask questions to understand your symptoms and their causes. […] This information can help your doctor make a diagnosis of asthma. […] The doctor may also ask if you get chest symptoms when you: […] Your doctor will do a physical exam to look for signs of asthma or other related conditions. […] To confirm asthma, your doctor may have you take one or more breathing tests known as lung function tests (also called pulmonary function tests). […] Lung function tests detect how well you inhale (breathe in) and exhale (breathe out) air from your lungs. […] If your doctor thinks you have something other than asthma or related to asthma, they may run other tests. […] Your health care provider may also check you for conditions such as:

• #1 Asthma: Steps in testing and diagnosis

  https://www.mayoclinic.org/diseases-conditions/asthma/in-depth/asthma/art-20045198

  Diagnosing asthma generally includes a medical history, physical exam and lung tests. […] An asthma diagnosis is based on several factors, including a detailed medical history, a physical exam, your symptoms, and overall health and test results. […] The first step in diagnosing asthma is talking to your healthcare team about your symptoms and your health. […] Your healthcare professional may use several tests to check how well your lungs are working. […] This is the main test doctors generally use to diagnose asthma in people 5 years or older. […] If certain measurements are below usual for a person your age, it may mean that asthma has narrowed your airways. […] If your spirometer results are typical or near typical, your healthcare professional might try to trigger asthma symptoms.

• #1 Asthma – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK430901/

  Asthma is a chronic inflammatory respiratory condition characterized by hallmark symptoms of intermittent dyspnea, cough, and wheezing. However, due to the nonspecific nature of these symptoms, distinguishing asthma from other respiratory illnesses can sometimes be challenging. A confirmed diagnosis of asthma relies on consistent respiratory symptoms and the identification of variable expiratory airflow obstruction documented on spirometry. […] Healthcare professionals establish a definitive diagnosis through patient history, physical examination, pulmonary function testing, and appropriate laboratory testing. Spirometry with a post-bronchodilator response (BDR) is the primary diagnostic test. […] Confirming the diagnosis involves the exclusion of alternative diagnoses and a demonstration of variable airflow limitation, usually seen in spirometry.

• #1 Asthma – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK430901/

  Spirometry assesses forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC) by measuring a maximal inhalation followed by rapid and forceful exhalation into a spirometer. Asthma typically presents as an obstructive pattern on spirometry, indicated by a reduced FEV1 to FVC ratio. […] Patients showing airflow limitations on spirometry receive 2 to 4 puffs of a short-acting bronchodilator like albuterol, followed by repeat spirometry in 10 to 15 minutes. According to the European Respiratory Society/American Thoracic Society guidelines, a positive BDR is determined by a change in FEV1 or FVC compared to their predicted value. […] During bronchoprovocation testing, clinicians induce bronchoconstriction using inhaled methacholine or mannitol, exercise, or eucapnic hyperventilation of dry air. This testing method can be beneficial for patients presenting with atypical symptoms or an isolated cough.

• #1 Asthma – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/asthma/diagnosis-treatment/drc-20369660

  Your doctor will perform a physical exam to rule out other possible conditions, such as a respiratory infection or chronic obstructive pulmonary disease (COPD). Your doctor will also ask you questions about your signs and symptoms and about any other health problems. […] You may be given lung function tests to determine how much air moves in and out as you breathe. These tests may include: […] Lung function tests often are done before and after taking a medication to open your airways called a bronchodilator (brong-koh-DIE-lay-tur), such as albuterol. If your lung function improves with use of a bronchodilator, it’s likely you have asthma. […] Other tests to diagnose asthma include: […] To classify your asthma severity, your doctor will consider how often you have signs and symptoms and how severe they are. Your doctor will also consider the results of your physical exam and diagnostic tests. […] Determining your asthma severity helps your doctor choose the best treatment. Asthma severity often changes over time, requiring treatment adjustments. […] Asthma is classified into four general categories:

• #1 Asthma Update: Part I. Diagnosis, Monitoring, and Prevention of Disease Progression | AAFP

  https://www.aafp.org/pubs/afp/issues/2004/0901/p893.html

  The NAEPP recommends the use of spirometry for initial assessment, evaluation of response to treatment, and assessment of airway function at least every one to two years. […] However, physicians should note that patients with asthma can have normal lung function. […] Disease severity is determined by pulmonary function measurements, asthma symptoms, and the need for rescue medication. […] Several factors can complicate the assessment of asthma severity. […] Objective measures of pulmonary function, such as PEF and forced expiratory volume in one second (FEV1), do not always correlate with the severity or frequency of asthma symptoms. […] The panel also reviewed the Childhood Asthma Management Program (CAMP) study, a large, prospective trial of more than 1,000 children with mild asthma. […] The CAMP study proved that inhaled corticosteroids are safe in children and provide excellent control of asthma, but the study was unable to prove that they modify the underlying disease.

• #1 Asthma – Diagnosis | NHLBI, NIH

  https://www.nhlbi.nih.gov/health/asthma/diagnosis

  Talk to your healthcare provider if you or your child have asthma symptoms. […] Your healthcare provider may want to run some tests to diagnose your asthma. […] Lung function tests measure how well you can breathe in and out: […] Spirometry measures how much air you breathe out and how fast. […] Peak expiratory flow (PEF) tests measure how fast you can blow air out using maximum effort. […] Bronchodilator responsiveness tests measure how much better you can blow air after inhaling a fast-acting bronchodilator, a medicine that helps open your airways by relaxing the muscles around them. […] Challenge tests, also called bronchial provocation tests, assess how sensitive your airways are. […] Your healthcare provider may want to run other tests to help diagnose your asthma. […] Allergy tests can find which allergens, such as pet dander or pollen, cause a reaction in your body when you are around them.

• #1 Asthma diagnosis: into the fourth dimension | Thorax

  https://thorax.bmj.com/content/76/6/624

  We provide an overview of the biological clock mechanism and highlight areas for future research. […] The measurement of diurnal variation in airway calibre in asthma is a key component of the diagnostic process. […] However, it is paramount to understand that diurnal variation is not an all or nothing phenomenon that is exclusively observed in asthma. […] Currently, PEF monitoring is the only diagnostic test used to demonstrate diurnal variability in asthma. […] The commonly used twice-daily readings may underestimate PEF variability by up to 15% and pick up only 20%45% of the true diurnal variation. […] The diurnal variation in bronchodilator reversibility can be significant even in well-controlled and fully treated asthmatics. […] Direct bronchial provocation challenges performed overnight have more profound effects than during the day.

• #1 Asthma: Updated Diagnosis and Management Recommendations from GINA | AAFP

  https://www.aafp.org/pubs/afp/issues/2020/0615/p762.html

  Bronchial provocation testing is useful for ruling out asthma but less useful for making the diagnosis, and it should be limited to diagnosing asthma in athletes or in patients with symptoms despite normal spirometry findings or when spirometry is unavailable. […] In patients taking controller treatment, it may be necessary to step down the dose to confirm an asthma diagnosis. Patients should be advised to reduce their inhaled corticosteroid (ICS) dose by 25% to 50% or stop any other long-acting medication.

• #1 Asthma – Diagnosis | NHLBI, NIH

  https://www.nhlbi.nih.gov/health/asthma/diagnosis

  Fractional exhaled nitric oxide (FeNO) tests measure how much nitric oxide is in your breath. […] High levels of nitric oxide may mean that your airways are inflamed, which can make it hard to breathe. […] Blood tests can measure levels of white blood cells, which can indicate inflammation. […] A chest CT scan may show whether the walls of your airways are thicker. […] Most diagnostic tests for asthma do not work well for young children. This can make it difficult to diagnose asthma in children.

• #1 Asthma – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK430901/

  Eosinophilic airway inflammation causes an upregulation of nitric oxide synthase in the respiratory mucosa, leading to elevated nitric oxide levels in exhaled breath. In certain asthma patients, the fractional exhaled nitric oxide (FENO) surpasses levels observed in individuals without asthma. A FENO of measurement exceeding 40 to 50 ppb can aid in confirming an asthma diagnosis.

• #1 Asthma diagnosis: into the fourth dimension | Thorax

  https://thorax.bmj.com/content/76/6/624

  Diurnal variation of FeNO in asthma has been established in a number of studies. […] The human biological clock is a remarkable built-in mechanism that is well integrated with the Earths rotation and changes in light, temperature and other environmental factors. […] The timing of asthma diagnostic tests matters: a schematic diagram demonstrating variability of asthma with time. […] The recommended fixed cut-off points for diagnostic tests should never be used in the absence of detailed clinical history and the consideration of timing of the test. […] Ascertaining circadian patterns of diagnostic tests in asthma and appropriate adjustment of the cut-off values according to timing of measurements may improve asthma diagnosis in some patients. […] This approach not only has the potential to empower patients in managing this highly variable disease, but also provides opportunities in creating a better patientclinician partnership.

• #1 Asthma Diagnosis and Testing – Allergy & Asthma Network

  https://allergyasthmanetwork.org/what-is-asthma/how-is-asthma-diagnosed/

  Diagnosing asthma is often difficult. For many, asthma symptoms tend to come and go. Thats why its important to talk with a doctor, preferably an asthma specialist, about your symptoms. Asthma specialists are board-certified allergists and pulmonologists who are familiar with asthma diagnosis and treatment guidelines. […] There is no single factor or test that confirms an asthma diagnosis. Rather it is like putting together a puzzle to see if everything fits. […] Your doctor may ask questions about your asthma symptoms, your medical history, and your family history. […] Doctors will watch the way your chest and stomach muscles move when you breathe. They will use a stethoscope to listen to air flowing in and out of your lungs. […] If asthma is suspected to be the cause, then diagnostic tests are needed. Part of diagnosing asthma includes breathing tests or lung function tests (also called pulmonary function tests). These tests measure lung function.

• #1 Asthma – diagnosis and follow-up control | Vivatmo

  https://www.vivatmo.com/en/asthma-magazine/information-about-asthma/asthma-diagnosis/

  During the subsequent physical examination, your doctor listens to your lungs with a stethoscope and watches out for typical breathing sounds caused by the asthma. […] Since in most cases asthma develops as a result of an allergy, it makes sense to have your doctor perform an allergy test. […] Extensive pulmonary function tests are usually performed by a specialist. […] Various lung function tests can be used to measure how well your lungs are currently performing, and clearly identify restrictions in lung function. […] In spirometry, lung function is tested using a spirometer, a device that measures the volume of inhaled or exhaled air. This provides important parameters for assessing the course and severity of the asthma. […] In many cases, after administering asthma medication to dilate the airways, a second measurement is taken to check the diagnosis. A bronchospasmolysis test is used to determine whether the constriction can be reduced through medication.

• #1 Diagnosing asthma | Asthma + Lung UK

  https://www.asthmaandlung.org.uk/conditions/asthma/diagnosing-asthma

  Find out how asthma is diagnosed, what to do if you have symptoms, and what to do if you are diagnosed with asthma. […] If you have asthma, its very important to get a diagnosis so that you can get the right medicines. […] At your appointment, your GP or a nurse will: consider any other symptoms that might suggest something other than asthma, test how your lungs are working, listen to your chest for any sounds of wheezing, consider prescribing asthma treatments to see if they make a difference. […] Your GP or nurse might suggest some asthma tests to see how your lungs are working. […] There are four main asthma tests: A blood test to measure your eosinophil (a type of white blood cell) levels, Fractional exhaled nitric oxide (FeNO) tests to measure the amount of inflammation in your airways, Spirometry tests to measure how much air you can blow out in one forced breath, Peak flow tests to measure how fast you can blow air out of your lungs.

• #1 Scientists Discover Potential Blood Test for Asthma Diagnosis and Severity | Rutgers Health

  https://rutgershealth.org/news/scientists-discover-potential-blood-test-asthma-diagnosis-and-severity

  Scientists at Rutgers Health have discovered that a simple blood test could diagnose asthma and determine its severity, a breakthrough that could transform how the disease is identified and monitored. […] The research team analyzed blood samples from 87 asthma patients and 273 participants without asthma. They found that cAMP levels were consistently higher in the blood of asthma patients and correlated with disease severity, potentially offering doctors a new tool for monitoring patient conditions. […] The development of this blood test could help doctors better identify which patients need more aggressive treatment and monitor their response to therapy more accurately.

• #1 Asthma Imaging and Diagnosis: Practice Essentials, Radiography, Computed Tomography

  https://emedicine.medscape.com/article/353436-overview

  Chest radiographic imaging is an important tool in the examination of patients with an exacerbation of asthma, but patients should not be left waiting in the treatment room for a radiograph before treatment. […] Chest radiography is the initial imaging evaluation in most individuals with symptoms of asthma. The value of chest radiography is in revealing complications or alternative causes of wheezing in the diagnosis of asthma and its exacerbations. […] Significant advancements have been made in a number of imaging techniques used for evaluating patients with asthma. […] HRCT is more costly than chest radiography and exposes the patient to more radiation. Nevertheless, CT scans can demonstrate a number of findings that support the diagnosis of asthma. […] HRCT remains the most sensitive study for morphologic changes associated with asthma.

• #1 Asthma Imaging and Diagnosis: Practice Essentials, Radiography, Computed Tomography

  https://emedicine.medscape.com/article/353436-overview

  Magnetic resonance imaging (MRI) that utilizes hyperpolarized gas can depict the regional distribution of ventilation defects in asthma across the entire lung. […] This recognition suggests that imaging has an important role in differentiating asthma from its mimics and that further diagnostic evaluation and treatment of nonasthma conditions may be necessary. […] When asthma does not respond to maintenance treatment, other possible diagnoses, such as cystic fibrosis, primary ciliary dyskinesia, immunodeficiency conditions, or airway and vascular malformations, must be excluded. […] In most patients with uncomplicated asthma, radiographic findings are normal. […] In early studies, lung opacity on chest radiography was evaluated in 8 regions in patients with asthma; the findings recapitulated the heterogeneous distribution of localized airtrapping seen on radioactive noble gas scintigrams obtained a decade earlier.

• #1 Asthma-Like Conditions | AAFA.org

  https://aafa.org/asthma/asthma-diagnosis/asthma-like-conditions/

  Some common symptoms of asthma include shortness of breath, wheezing, coughing, and chest tightness. To make a diagnosis, your doctor will look at your medical history and perform a physical exam. They may also do lung function tests. […] One study showed that one out of three people diagnosed with asthma didn’t actually have the condition. […] Make sure you talk with your doctor if your asthma treatment is not controlling your symptoms. Getting the right diagnosis can mean a better quality of life. […] When asthma doesn’t respond to asthma medicine, some doctors prescribe oral corticosteroids. […] If you have been following an asthma treatment plan but it isn’t helping, talk with your doctor. […] Methacholine is a type of drug that will tighten your airways at a lower dose if you have asthma. […] If your lungs do not react to lower doses of methacholine, you may have another condition that has similar symptoms to asthma.

• #1 Asthma Diagnosis, Education and Management – Province of British Columbia

  https://www2.gov.bc.ca/gov/content/health/practitioner-professional-resources/bc-guidelines/asthma

  Wheezing is the most specific sign of asthma. […] Other symptoms associated with asthma include chest tightness, dyspnea, and cough. […] Since children under the age of 6 cannot do spirometry reliably, the diagnosis of asthma is based on physical exam findings and response to medication as objective evidence of reversible airflow obstruction. Once they reach the age of 6, the diagnosis can be confirmed with spirometry. […] Spirometry is a test performed to assess an individual’s pulmonary function. It can be used to establish a diagnosis, monitor disease progress, or evaluate the effect of therapeutic interventions. […] When spirometry results are negative and clinical suspicion remains, the following tests may be helpful in diagnosing asthma: Methacholine challenge or an exercise challenge can be done. […] Up to 30% of patients with a physician diagnosis of asthma are misdiagnosed. Spirometry is the best first-line test for diagnosis and should be pursued to avoid misdiagnosis.

• #1 Asthma Diagnosis | AAFA.org

  https://aafa.org/asthma/asthma-diagnosis/

  The answers to these questions help to determine the severity of your asthma. […] You may also hear about different types of asthma from your doctor or other people. […] Type 2 inflammation is an allergic immune response involved in some types of asthma, such as allergic asthma and eosinophilic asthma. […] Diagnosing asthma in children under age 5 is a little different.

• #1 Asthma Diagnosis and Testing – Allergy & Asthma Network

  https://allergyasthmanetwork.org/what-is-asthma/how-is-asthma-diagnosed/

  No single test is used to diagnose asthma, but each is a piece of the puzzle. […] Diagnosing asthma in adults includes reviewing symptoms, family history and a physical exam. If your symptoms suggest asthma, then the doctor may recommend lung function testing to confirm the diagnosis. […] In children under the age of 5, most asthma lung function tests are not reliable. So asthma in young children is primarily diagnosed based on symptoms, family and health history, and a physical exam. […] Occupational asthma is diagnosed the same as other types of asthma. […] There are other types of respiratory conditions that are different than asthma. The symptoms, diagnosis and treatment can vary depending upon the condition.

• #1 How to Be Diagnosed with Asthma: For Children and Adults

  https://www.healthline.com/health/asthma/how-to-be-diagnosed-with-asthma

  Diagnostic breathing tests, like spirometry and FeNO, are common ways for doctors to confirm an asthma diagnosis in older children and adults. […] But asthma often begins in young childhood, and there’s no definite diagnostic test for this age group. Instead, doctors will suspect and treat asthma based on a child’s symptoms and examination, and they’ll continue to monitor the child closely as they grow.

• #1 Diagnosing Work-related Asthma | Asthma | CDC

  https://www.cdc.gov/niosh/asthma/hcp/diagnosing/index.html

  Diagnosing work-related asthma is based on a combination of medical and exposure history, physical examination, and medical tests such as pulmonary function tests. […] Consider work-related asthma as a possibility in all working patients. […] An increase in using rescue inhalers can be an early indication that asthma is progressing. […] The American Thoracic Society has guidelines on how to perform and interpret pulmonary function tests such as spirometry. […] Serial measurements of peak expiratory flow might be useful for evaluating work-related asthma. […] The presence of reversibility may support an asthma diagnosis. […] If spirometry is normal but asthma is suspected, bronchial hyperresponsiveness can be assessed using nonspecific bronchial responsive testing (e.g., methacholine or mannitol challenge tests). […] Increased fractional exhaled nitric oxide levels support allergic asthma diagnosis but does not differentiate between work-related asthma and non-work related. […] A normal fractional exhaled nitric oxide level does not rule out work-related asthma.

• #1 Diagnosis & Treatment | EOS Asthma Toolkit

  https://eosasthma.org/diagnosis-treatment/

  A diagnosis of eosinophilic asthma is important to determine effective treatments. […] There are three ways that eos asthma may be diagnosed. […] The number of eosinophils in a patients blood are measured. […] High eosinophils with asthma does not always mean that a person has eosinophilic asthma. […] A patients sputum sample is examined under a microscope. […] Having more than 2-3% of cells being eosinophilic in the sputum suggests eosinophilic asthma. […] A patients bronchial biopsy or bronchial fluid from the lung is examined under a microscope. […] This procedure is performed under local or general anesthesia but usually does not require a hospital stay.

• #1 Asthma: Diagnosis and Treatment – European Medical Journal

  https://www.emjreviews.com/respiratory/article/asthma-diagnosis-and-treatment/

  For patients with exercise-induced bronchoconstriction (EIB), exercise challenge testing can be used for diagnosis. […] Understanding the severity of a disease is important for its management. The NAEPP defines severity as the intrinsic intensity of the disease prior to treatment with long-term control therapy; an understanding of disease severity to initiate therapy and achieve control of the disease is emphasised in NAEPP guidelines. […] Asthma severity is divided into intermittent, mild, moderate, and severe and persistent. […] Since asthma is a clinical disease and spirometric measurements do not always reflect a patient’s disease severity, symptom control questionnaires have been developed and validated as a quantitative assessment of patient symptoms. […] Asthma is a chronic airway disease of varying pathophysiology, which includes eosinophilic, neutrophilic, mixed granulocytic, and paucigranulocytic pathways.

• #1 Asthma – Wikipedia

  https://en.wikipedia.org/wiki/Asthma

  Asthma is clinically classified according to the frequency of symptoms, forced expiratory volume in one second (FEV1), and peak expiratory flow rate. […] Asthma may also be classified as atopic (extrinsic) or non-atopic (intrinsic), based on whether symptoms are precipitated by allergens (atopic) or not (non-atopic).

• #1 Asthma diagnosis: into the fourth dimension | Thorax

  https://thorax.bmj.com/content/76/6/624

  Asthma is the most common chronic respiratory disease in the UK; however, the misdiagnosis rate is substantial. […] The lack of consistency in national guidelines and the paucity of data on the performance of diagnostic algorithms compound the challenges in asthma diagnosis. […] Almost all established asthma diagnostic tools demonstrate diurnal variation, yet few are performed with standardised timing of measurements. […] The dichotomous interpretation of diagnostic outcomes using fixed cut-off values may further limit the accuracy of the tests, particularly when diurnal variability straddles cut-off values within a day, and careful interpretation beyond the positive and negative outcome is needed. […] Accurate asthma diagnosis is pivotal in achieving good disease outcome and has important implications in the effective use of healthcare resources, but why is the misdiagnosis rate so high?

• #1 Asthma diagnosis: into the fourth dimension | Thorax

  https://thorax.bmj.com/content/76/6/624

  In spite of this complexity, the clinical features of asthma include (some or all of) reversible airflow obstruction, airway inflammation and bronchial hyper-responsiveness (BHR). […] All the currently available diagnostic tests are aimed at demonstrating one or more of these features. […] In a population-based birth cohort study, the asthma diagnostic algorithm for children recommended by the National Institute for Health and Care Excellence (NICE) was applied to 772 children. […] This raises concerns over the potential for delayed diagnosis in children or misdiagnosis; the comprehensive review of the literature that accompanied this guidance clearly demonstrated the paucity of evidence for the use of spirometry and bronchodilator reversibility in children. […] Despite this, the diagnostic guidelines continue to predominantly rely on using fixed and arbitrary cut-off values in the interpretation of tests, with little emphasis on the timing of measurements and how this may affect diagnostic accuracy.

• #1

  https://link.springer.com/article/10.1007/s41030-019-0093-y

  Asthma, the most common chronic respiratory disease, is frequently misdiagnosed, and accounts for a significant proportion of healthcare expenditure. […] Asthma has been shown to be underdiagnosed across all countries irrespective of the level of development. […] Accurate diagnosis is vital in order to optimise health and improve quality of life and survival. […] The first published national asthma guidelines were developed by the Thoracic Society of Australia and New Zealand in 1989. […] Recent literature has taken us back to thinking about asthma by its original descriptive and symptom-focused roots rather than describing a discrete disease entity. […] There is now a need to highlight the underlying cause of the asthma symptoms experienced by a patient in order to prescribe the most effective drug.

• #1 How Is Asthma Diagnosed? | American Lung Association

  https://www.lung.org/lung-health-diseases/lung-disease-lookup/asthma/symptoms-diagnosis/how-is-asthma-diagnosed

  Asthma is a disease that requires a diagnosis by a healthcare professional and ongoing assessments and monitoring throughout your lifetime. […] If you or your child experience symptoms such as wheezing, frequent cough, shortness of breath or chest tightness, it is important to see a healthcare provider to determine if the symptoms point to asthma. […] To diagnose asthma, a doctor will evaluate these symptoms, ask for complete health history, conduct a physical exam and look at test results. […] At the initial visit, your asthma care provider will determine your level of severity and create a treatment plan. At each follow-up visit, they will assess your asthma control and adjust your treatment plan as needed. […] There are also several breathing tests your healthcare provider may perform. The most common lung function test is called spirometry. This lung function test uses a device called, a spirometer, to measure the amount and speed of the air you blow out. This helps your healthcare provider see how well your lungs are working.

• #1 Diagnosing Asthma – Asthma Canada

  https://asthma.ca/get-help/diagnosis/

  Some people who have asthma will have a normal spirometry test. If this is the case, you may be asked to take another test to confirm the diagnosis of asthma, like a methacholine challenge or exercise test. […] If you are diagnosed with asthma, a healthcare practitioner will create a customized treatment plan known as an Asthma Action Plan that fits your particular needs, lifestyle and triggers, as well as the frequency and intensity of your symptoms.

• #1

  https://link.springer.com/article/10.1007/s41030-019-0093-y

  Another recent guideline on diagnosis and management of asthma was produced by NICE. […] The guideline therefore recommends compulsory objective investigations for asthma diagnosis. […] The NICE algorithm is the first to move towards such an approach, by including a non-invasive type II biomarker (high FeNO) that is predictive of corticosteroid responsiveness. […] The future is likely to see the development of personalised medicine, further enabling the best treatment for each individual patient. […] Over the next decade it is likely that we will see the emergence of novel investigations of the small airways enter the asthma diagnostic pathway.

• #1 The key to easy asthma diagnosis is in the blood

  https://news.wisc.edu/the-key-to-easy-asthma-diagnosis-is-in-the-blood/

  Currently, asthma diagnosis consists of a series of clinical tests, often heavily informed by lung functionality tests. […] Many of the current tests for diagnosing asthma rely at least partially on the patient experiencing symptoms during or close to their physician visit. […] Right now, asthma diagnosis is based on indirect measures, Beebe says, which is not optimal. […] So the premise in this paper was that cell function could be used to diagnose asthma and that we could measure cell function in way that was simple and cheap enough to be used clinically. […] To directly diagnose asthma, Beebe and his team focused on the cell function of neutrophils. […] Researchers can track the velocity at which the neutrophil cells migrate the chemotaxis velocity to differentiate nonasthmatic samples from the significantly reduced chemotaxis velocity of asthmatic patients.

• #2 Asthma – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK430901/

  Asthma is a chronic inflammatory respiratory condition characterized by hallmark symptoms of intermittent dyspnea, cough, and wheezing. However, due to the nonspecific nature of these symptoms, distinguishing asthma from other respiratory illnesses can sometimes be challenging. A confirmed diagnosis of asthma relies on consistent respiratory symptoms and the identification of variable expiratory airflow obstruction documented on spirometry. […] Healthcare professionals establish a definitive diagnosis through patient history, physical examination, pulmonary function testing, and appropriate laboratory testing. Spirometry with a post-bronchodilator response (BDR) is the primary diagnostic test. […] Confirming the diagnosis involves the exclusion of alternative diagnoses and a demonstration of variable airflow limitation, usually seen in spirometry.

• #2 Diagnosing asthma in adults and young people 16+ | Asthma + Lung UK

  https://www.asthmaandlung.org.uk/healthcare-professionals/adult-asthma/diagnosis-testing/diagnosing-asthma-adults

  The diagnosis of asthma is like a jigsaw. […] It is important to remember that in asthma the symptoms, clinical examination findings and test results can vary over time and sometimes its necessary to re-examine patients and repeat tests when they have their symptoms. […] There is no single diagnostic test for asthma. Diagnosis is based on a structured clinical assessment supported by objective tests that show airway inflammation or variable airflow obstruction. […] Your first step should be to take a detailed clinical assessment. […] Night time or early morning symptoms are a sign of uncontrolled asthma. […] Symptoms in response to specific triggers make an asthma diagnosis more likely. […] Having a raised blood eosinophil count is a marker for asthma. […] Absence of wheeze does not rule out asthma as a diagnosis.

• #2 How Is Asthma Diagnosed? | American Lung Association

  https://www.lung.org/lung-health-diseases/lung-disease-lookup/asthma/symptoms-diagnosis/how-is-asthma-diagnosed

  Asthma is a disease that requires a diagnosis by a healthcare professional and ongoing assessments and monitoring throughout your lifetime. […] If you or your child experience symptoms such as wheezing, frequent cough, shortness of breath or chest tightness, it is important to see a healthcare provider to determine if the symptoms point to asthma. […] To diagnose asthma, a doctor will evaluate these symptoms, ask for complete health history, conduct a physical exam and look at test results. […] At the initial visit, your asthma care provider will determine your level of severity and create a treatment plan. At each follow-up visit, they will assess your asthma control and adjust your treatment plan as needed. […] There are also several breathing tests your healthcare provider may perform. The most common lung function test is called spirometry. This lung function test uses a device called, a spirometer, to measure the amount and speed of the air you blow out. This helps your healthcare provider see how well your lungs are working.

• #2 Diagnosis | Florida Department of Health

  https://www.floridahealth.gov/diseases-and-conditions/asthma/diagnosis/index.html

  Your primary care doctor will diagnose asthma based on your medical and family histories, a physical exam, and test results. Your doctor will also determine the severity of your asthma to establish what treatment options are available for you. […] Asthma symptoms can mimic several other conditions, and your doctor will take a thorough history to rule these out. Your doctor may ask you about related health conditions that can interfere with asthma management. These conditions include a nasal allergy, sinus infections, reflux disease, psychological stress, and sleep apnea. […] You may also have lung function tests to measure how much air your lungs can hold and how much air you breathe out. Your doctor may use a spirometer to measure how much air you exhale and how quickly you get air out of your lungs. Other tests may include chest and sinus x-rays, blood tests, or allergy tests.

• #2 Asthma – diagnosis and follow-up control | Vivatmo

  https://www.vivatmo.com/en/asthma-magazine/information-about-asthma/asthma-diagnosis/

  Pulmonologists (specialists in pulmonary medicine) have various methods at their disposal for diagnosing and determining the type of asthma. In addition to a detailed discussion of the patient’s medical history (anamnesis), these include physical examinations, allergy tests, various lung function tests, chest imaging procedures such as ultrasound, X-ray, CT, MRI, and blood tests. […] Permanent monitoring of the disease is at least as important as the correct diagnosis. Follow-up is extremely important and requires the active cooperation of the patient. […] If you experience breathing difficulties, you should not delay a visit to your doctor unnecessarily. […] A good doctor-patient relationship is built on trust, and this starts with a detailed medical consultation. […] During the consultation, your doctor will be looking out for typical signs of asthma, for example a pale complexion or a bluish discoloration of your fingers and lips, which indicate an oxygen deficiency.

• #2 Asthma – Wikipedia

  https://en.wikipedia.org/wiki/Asthma

  Asthma is thought to be caused by a combination of genetic and environmental factors. […] Diagnosis is usually based on the pattern of symptoms, response to therapy over time, and spirometry lung function testing. […] There is currently no precise test for the diagnosis, which is typically based on the pattern of symptoms and response to therapy over time. […] Spirometry is recommended to aid in diagnosis and management. […] Spirometry is the single best test for asthma. […] The methacholine challenge involves the inhalation of increasing concentrations of a substance that causes airway narrowing in those predisposed. […] Other supportive evidence includes: a 20% difference in peak expiratory flow rate on at least three days in a week for at least two weeks, a 20% improvement of peak flow following treatment with either salbutamol, inhaled corticosteroids or prednisone, or a 20% decrease in peak flow following exposure to a trigger.

• #2 Asthma: Diagnosis and Treatment – European Medical Journal

  https://www.emjreviews.com/respiratory/article/asthma-diagnosis-and-treatment/

  Currently, the Global Initiative for Asthma (GINA) and National Asthma Education Prevention Program (NAEPP) recommend spirometry testing in patients suspected of having asthma. Asthma is characterised by variable airway obstruction and hyper-responsiveness; airflow obstruction with a FEV1/forced vital capacity ratio 0.7 or less than the lower limit of normal (LLN) and airflow reversibility after inhalation of a short-acting beta-2 agonist (SABA) defined as FEV1 improvement by at least 12% and 200 mL indicates a diagnosis of asthma. […] In such patients with normal spirometry results, bronchoprovocation with methacholine or mannitol can be useful in the asthma diagnosis. […] Nitric oxide (NO) produced by the airway epithelium is an indirect marker of elevated airway inflammation. The level of NO in exhaled breath can easily be measured and has been used for detecting airway inflammation in patients suspected of and with the diagnosis of asthma.

• #2 Asthma – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK430901/

  Spirometry assesses forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC) by measuring a maximal inhalation followed by rapid and forceful exhalation into a spirometer. Asthma typically presents as an obstructive pattern on spirometry, indicated by a reduced FEV1 to FVC ratio. […] Patients showing airflow limitations on spirometry receive 2 to 4 puffs of a short-acting bronchodilator like albuterol, followed by repeat spirometry in 10 to 15 minutes. According to the European Respiratory Society/American Thoracic Society guidelines, a positive BDR is determined by a change in FEV1 or FVC compared to their predicted value. […] During bronchoprovocation testing, clinicians induce bronchoconstriction using inhaled methacholine or mannitol, exercise, or eucapnic hyperventilation of dry air. This testing method can be beneficial for patients presenting with atypical symptoms or an isolated cough.

• #2 Asthma: Steps in testing and diagnosis

  https://www.mayoclinic.org/diseases-conditions/asthma/in-depth/asthma/art-20045198

  Diagnosing asthma generally includes a medical history, physical exam and lung tests. […] An asthma diagnosis is based on several factors, including a detailed medical history, a physical exam, your symptoms, and overall health and test results. […] The first step in diagnosing asthma is talking to your healthcare team about your symptoms and your health. […] Your healthcare professional may use several tests to check how well your lungs are working. […] This is the main test doctors generally use to diagnose asthma in people 5 years or older. […] If certain measurements are below usual for a person your age, it may mean that asthma has narrowed your airways. […] If your spirometer results are typical or near typical, your healthcare professional might try to trigger asthma symptoms.

• #2 Asthma – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK430901/

  Eosinophilic airway inflammation causes an upregulation of nitric oxide synthase in the respiratory mucosa, leading to elevated nitric oxide levels in exhaled breath. In certain asthma patients, the fractional exhaled nitric oxide (FENO) surpasses levels observed in individuals without asthma. A FENO of measurement exceeding 40 to 50 ppb can aid in confirming an asthma diagnosis.

• #2 Diagnosing Work-related Asthma | Asthma | CDC

  https://www.cdc.gov/niosh/asthma/hcp/diagnosing/index.html

  Diagnosing work-related asthma is based on a combination of medical and exposure history, physical examination, and medical tests such as pulmonary function tests. […] Consider work-related asthma as a possibility in all working patients. […] An increase in using rescue inhalers can be an early indication that asthma is progressing. […] The American Thoracic Society has guidelines on how to perform and interpret pulmonary function tests such as spirometry. […] Serial measurements of peak expiratory flow might be useful for evaluating work-related asthma. […] The presence of reversibility may support an asthma diagnosis. […] If spirometry is normal but asthma is suspected, bronchial hyperresponsiveness can be assessed using nonspecific bronchial responsive testing (e.g., methacholine or mannitol challenge tests). […] Increased fractional exhaled nitric oxide levels support allergic asthma diagnosis but does not differentiate between work-related asthma and non-work related. […] A normal fractional exhaled nitric oxide level does not rule out work-related asthma.

• #2 Diagnosing asthma | Asthma + Lung UK

  https://www.asthmaandlung.org.uk/conditions/asthma/diagnosing-asthma

  Find out how asthma is diagnosed, what to do if you have symptoms, and what to do if you are diagnosed with asthma. […] If you have asthma, its very important to get a diagnosis so that you can get the right medicines. […] At your appointment, your GP or a nurse will: consider any other symptoms that might suggest something other than asthma, test how your lungs are working, listen to your chest for any sounds of wheezing, consider prescribing asthma treatments to see if they make a difference. […] Your GP or nurse might suggest some asthma tests to see how your lungs are working. […] There are four main asthma tests: A blood test to measure your eosinophil (a type of white blood cell) levels, Fractional exhaled nitric oxide (FeNO) tests to measure the amount of inflammation in your airways, Spirometry tests to measure how much air you can blow out in one forced breath, Peak flow tests to measure how fast you can blow air out of your lungs.

• #2 Asthma diagnosis and tests

  https://www2.hse.ie/conditions/asthma/diagnosing-asthma/

  Your GP can often diagnose asthma from your symptoms and some tests. […] They may ask you to do some breathing tests. This is to confirm if you have asthma. […] Your GP may refer you to an integrated care hub (care hub) if: you need spirometry or other breathing tests. […] Spirometry is a test to diagnose and monitor certain lung conditions. […] Your GP or specialist may do other tests to confirm asthma or asthma triggers. […] FeNO stands for fractional exhaled nitric oxide. You breathe into a device that measures the level of nitric oxide in your breath. […] The level of nitric oxide can show: how inflamed your airways are, if you have certain types of allergic asthma. […] You breathe in a powder or mist that can irritate your airways and make them get narrower. The test shows how sensitive your airways are. […] Your GP or care hub team may refer you for skin testing. This is to see if you are allergic to common allergens that can trigger asthma.

• #2 Diagnosing Childhood Asthma | Doctor

  https://patient.info/doctor/diagnosing-childhood-asthma-in-primary-care

  NICE recommends the following strategy for confirming an asthma diagnosis: […] If asthma is not confirmed by FeNO, BDR, or PEF variability, but is still suspected clinically, either perform skin prick testing to house dust mite or measure total IgE level and blood eosinophil count. […] If there is still diagnostic doubt, refer to a paediatric specialist for a second opinion and consideration of a bronchial challenge test.

• #2 Asthma Imaging and Diagnosis: Practice Essentials, Radiography, Computed Tomography

  https://emedicine.medscape.com/article/353436-overview

  Magnetic resonance imaging (MRI) that utilizes hyperpolarized gas can depict the regional distribution of ventilation defects in asthma across the entire lung. […] This recognition suggests that imaging has an important role in differentiating asthma from its mimics and that further diagnostic evaluation and treatment of nonasthma conditions may be necessary. […] When asthma does not respond to maintenance treatment, other possible diagnoses, such as cystic fibrosis, primary ciliary dyskinesia, immunodeficiency conditions, or airway and vascular malformations, must be excluded. […] In most patients with uncomplicated asthma, radiographic findings are normal. […] In early studies, lung opacity on chest radiography was evaluated in 8 regions in patients with asthma; the findings recapitulated the heterogeneous distribution of localized airtrapping seen on radioactive noble gas scintigrams obtained a decade earlier.

• #2 Asthma – Pulmonary Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/pulmonary-disorders/asthma-and-related-disorders/asthma

  Asthma that is difficult to control or refractory to commonly used controller therapies should be further evaluated for alternative causes of episodic wheezing, cough, and dyspnea such as allergic bronchopulmonary aspergillosis, bronchiectasis, asthma-COPD overlap, alpha-1 antitrypsin deficiency, cystic fibrosis, or vocal cord dysfunction.

• #2 Asthma – Diagnosis | NHLBI, NIH

  https://www.nhlbi.nih.gov/health/asthma/diagnosis

  Fractional exhaled nitric oxide (FeNO) tests measure how much nitric oxide is in your breath. […] High levels of nitric oxide may mean that your airways are inflamed, which can make it hard to breathe. […] Blood tests can measure levels of white blood cells, which can indicate inflammation. […] A chest CT scan may show whether the walls of your airways are thicker. […] Most diagnostic tests for asthma do not work well for young children. This can make it difficult to diagnose asthma in children.

• #2 How Is Asthma Diagnosed? | American Lung Association

  https://www.lung.org/lung-health-diseases/lung-disease-lookup/asthma/symptoms-diagnosis/how-is-asthma-diagnosed

  Lung function tests are often used to make an asthma diagnosis, but they are very hard to do with young children. The doctor may use a 4- to 6-week trial of asthma medicines to see if they make a difference in your child’s symptoms. […] If you are diagnosed with asthma, you and your doctor will discuss a treatment plan just for you, including the use of medicines.

• #2 Patient education: Asthma symptoms and diagnosis in children (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/asthma-symptoms-and-diagnosis-in-children-beyond-the-basics

  Challenge testing — A bronchial challenge test may be recommended to diagnose asthma. This testing is designed to cause the airways to narrow in children with asthma. […] Additional testing — Other tests may be recommended to ensure that another condition is not the cause of a child’s coughing or wheezing. […] Testing for young children — Infants and children younger than six years are usually not able to reliably perform spirometry or peak expiratory flow rate testing. In some cases, a health care provider may recommend a trial of asthma medication to confirm the diagnosis.

• #2 Asthma Diagnosis | AAFA.org

  https://aafa.org/asthma/asthma-diagnosis/

  The answers to these questions help to determine the severity of your asthma. […] You may also hear about different types of asthma from your doctor or other people. […] Type 2 inflammation is an allergic immune response involved in some types of asthma, such as allergic asthma and eosinophilic asthma. […] Diagnosing asthma in children under age 5 is a little different.

• #2

  https://link.springer.com/article/10.1007/s41030-019-0093-y

  Asthma, the most common chronic respiratory disease, is frequently misdiagnosed, and accounts for a significant proportion of healthcare expenditure. […] Asthma has been shown to be underdiagnosed across all countries irrespective of the level of development. […] Accurate diagnosis is vital in order to optimise health and improve quality of life and survival. […] The first published national asthma guidelines were developed by the Thoracic Society of Australia and New Zealand in 1989. […] Recent literature has taken us back to thinking about asthma by its original descriptive and symptom-focused roots rather than describing a discrete disease entity. […] There is now a need to highlight the underlying cause of the asthma symptoms experienced by a patient in order to prescribe the most effective drug.

• #2 Diagnosis and management of asthma in children | BMJ Paediatrics Open

  https://bmjpaedsopen.bmj.com/content/6/1/e001277

  Asthma is the the most common chronic respiratory condition of childhood worldwide, with around 14% of children and young people affected. […] There are several diagnostic challenges, and as a result, both overdiagnosis and underdiagnosis of paediatric asthma remain problematic. […] Diagnosing asthma in childhood can be challenging, and the diagnosis should be reviewed during follow-up to ensure it is correct. […] There is no single gold-standard test that can be used to accurately diagnose asthma. In practice, a diagnosis should be made based on characteristic symptom patterns, evidence of variability in airflow limitation in the presence of airway inflammation, likelihood of alternative diagnoses and response to treatment. […] The diagnosis of asthma should therefore be reviewed routinely to identify true asthma and alter treatment where necessary.

• #2 Asthma diagnosis: into the fourth dimension | Thorax

  https://thorax.bmj.com/content/76/6/624

  Diurnal variation of FeNO in asthma has been established in a number of studies. […] The human biological clock is a remarkable built-in mechanism that is well integrated with the Earths rotation and changes in light, temperature and other environmental factors. […] The timing of asthma diagnostic tests matters: a schematic diagram demonstrating variability of asthma with time. […] The recommended fixed cut-off points for diagnostic tests should never be used in the absence of detailed clinical history and the consideration of timing of the test. […] Ascertaining circadian patterns of diagnostic tests in asthma and appropriate adjustment of the cut-off values according to timing of measurements may improve asthma diagnosis in some patients. […] This approach not only has the potential to empower patients in managing this highly variable disease, but also provides opportunities in creating a better patientclinician partnership.

• #2 Understanding the Diagnosis and Treatment of Asthma

  https://www.lanermc.org/community/lane-health-blog/understanding-the-diagnosis-and-treatment-of-asthma

  Once diagnosed, managing asthma is all about keeping symptoms under control and preventing asthma attacks. […] Your doctor will work with you to develop a personalized asthma action plan, which outlines how to manage your symptoms on a daily basis and what to do during an asthma attack. […] Regular check-ups with your doctor are crucial to monitor your symptoms, assess your lung function, and adjust your treatment plan as needed. […] If your asthma seems to be worsening, contact your healthcare provider for a reassessment of your condition and treatment. […] Early diagnosis and effective treatment can significantly improve your quality of life and prevent asthma attacks.

• #2 The key to easy asthma diagnosis is in the blood

  https://news.wisc.edu/the-key-to-easy-asthma-diagnosis-is-in-the-blood/

  However, UWMadison students developed the kit-on-a-lid-assay (KOALA) microfluidic technology, which allows them to detect neutrophils using just a single drop of blood. […] The KOALA diagnostic procedure is very simple. […] The technology means doctors could diagnose asthma even if their patients are not experiencing symptoms during their visit to the clinic. […] Beebe emphasizes that by using the KOALA lids containing premixed chemicals, the diagnostic procedure is scalable, cheap, quick and repeatable.

• #3 Asthma: Diagnosis and Treatment – European Medical Journal

  https://www.emjreviews.com/respiratory/article/asthma-diagnosis-and-treatment/

  Currently, the Global Initiative for Asthma (GINA) and National Asthma Education Prevention Program (NAEPP) recommend spirometry testing in patients suspected of having asthma. Asthma is characterised by variable airway obstruction and hyper-responsiveness; airflow obstruction with a FEV1/forced vital capacity ratio 0.7 or less than the lower limit of normal (LLN) and airflow reversibility after inhalation of a short-acting beta-2 agonist (SABA) defined as FEV1 improvement by at least 12% and 200 mL indicates a diagnosis of asthma. […] In such patients with normal spirometry results, bronchoprovocation with methacholine or mannitol can be useful in the asthma diagnosis. […] Nitric oxide (NO) produced by the airway epithelium is an indirect marker of elevated airway inflammation. The level of NO in exhaled breath can easily be measured and has been used for detecting airway inflammation in patients suspected of and with the diagnosis of asthma.

Zobacz więcej