Choosing Wisely:

Don’t diagnose or manage asthma without spirometry.

Rationale and Comments: Clinicians often rely solely upon symptoms when diagnosing and managing asthma, but these symptoms may be misleading and be from alternate causes. Therefore, spirometry is essential to confirm the diagnosis in those patients who can perform this procedure. Recent guidelines highlight spirometry’s value in stratifying disease severity and monitoring control. History and physical exam alone may over- or underestimate asthma control. Beyond the increased costs of care, repercussions of misdiagnosing asthma include delaying a correct diagnosis and treatment.
Sponsoring Organizations:
  • American Academy of Allergy, Asthma and Immunology
  • Sources:
  • National Asthma Education and Prevention Expert Panel report
  • Disciplines:
  • Pulmonary medicine
  • References: • National Asthma Education and Prevention Expert Panel Report 3: Guidelines for the diagnosis and management of asthma. NIH Publication no. 08-5846. October 2007.
    • Li J, et al. Attaining asthma control. A practice parameter. J Allergy Clin Immunol. 2005;115:S3-11.
    • Global strategy for asthma management and prevention: GINA executive summary. Eur Respir J. 2008;31:143-78.
    • Fuhlbrigge A, et. al. FEV1 is associated with risk of asthma attacks in a pediatric population. J Allergy Clin Immunol. 2001;107:61-6.
    • Magadle R. The risk of hospitalization and near-fatal and fatal asthma in relation to the perception of dyspnea. Chest. 2002;121:329-33.

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