Diagnosis of asthma: Diagnostic testing

Research output: Contribution to journalArticle

Abstract

Background: Asthma is a heterogeneous disease, encompassing both atopic and non-atopic phenotypes. Diagnosis of asthma is based on the combined presence of typical symptoms and objective tests of lung function. Objective diagnostic testing consists of 2 components: (1) demonstration of airway obstruction, and (2) documentation of variability in degree of obstruction. Methods: A review of current guidelines and literature was performed regarding diagnostic testing for asthma. Results: Spirometry with bronchodilator reversibility testing remains the mainstay of asthma diagnostic testing for children and adults. Repetition of the test over several time points may be necessary to confirm airway obstruction and variability thereof. Repeated peak flow measurement is relatively simple to implement in a clinical and home setting. Bronchial challenge testing is reserved for patients in whom the aforementioned testing has been unrevealing but clinical suspicion remains, though is associated with low specificity. Demonstration of eosinophilic inflammation, via fractional exhaled nitric oxide measurement, or atopy, may be supportive of atopic asthma, though diagnostic utility is limited particularly in nonatopic asthma. All efforts should be made to confirm the diagnosis of asthma in those who are being presumptively treated but have not had objective measurements of variability in the degree of obstruction. Conclusion: Multiple testing modalities are available for objective confirmation of airway obstruction and variability thereof, consistent with a diagnosis of asthma in the appropriate clinical context. Providers should be aware that both these characteristics may be present in other disease states, and may not be specific to a diagnosis of asthma.

Original languageEnglish (US)
Pages (from-to)S27-S30
JournalInternational Forum of Allergy and Rhinology
Volume5
DOIs
StatePublished - Sep 1 2015

Fingerprint

Asthma
Airway Obstruction
Bronchodilator Agents
Spirometry
Respiratory Function Tests
Documentation
Nitric Oxide
Guidelines
Inflammation
Phenotype

Keywords

  • Airway obstruction
  • Asthma
  • Chronic pulmonary disease
  • Diagnosis of asthma
  • Diagnostic testing
  • Peak flow measurement
  • Spirometry

ASJC Scopus subject areas

  • Immunology and Allergy
  • Otorhinolaryngology

Cite this

Diagnosis of asthma : Diagnostic testing. / Brigham, Emily; West, Natalie E.

In: International Forum of Allergy and Rhinology, Vol. 5, 01.09.2015, p. S27-S30.

Research output: Contribution to journalArticle

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