Timeliness of diagnosis of asthma in children and its predictors
Article first published online: 10 OCT 2008
© 2008 The Authors. Journal compilation © 2008 Blackwell Munksgaard
Volume 63, Issue 11, pages 1529–1535, November 2008
How to Cite
Molis, W. E., Bagniewski, S., Weaver, A. L., Jacobson, R. M. and Juhn, Y. J. (2008), Timeliness of diagnosis of asthma in children and its predictors. Allergy, 63: 1529–1535. doi: 10.1111/j.1398-9995.2008.01749.x
- Issue published online: 10 OCT 2008
- Article first published online: 10 OCT 2008
- Accepted for publication 11 March 2008
Background: There is a paucity of literature using medical records to evaluate the timeliness of asthma diagnosis in children and the predictors associated with timeliness of asthma diagnosis.
Methods: Subjects were obtained from a convenience sample of 839 children, aged 5–13 years. We conducted comprehensive medical record reviews for these children to determine their asthma status by applying predetermined criteria for asthma. Predictors were evaluated for an association with timeliness of asthma diagnosis.
Results: Of 839 children, 276 children met the criteria for asthma before 18 years of age. Of these subjects, 97 had timely diagnosis of asthma while 179 did not have timely diagnosis of asthma with the median delay of 3.3 years. Children with definite asthma at the time of index date was three times more timely to be diagnosed with asthma [hazard ratios (HR) 3.3, 95% CI: 2.43–4.47, P < 0.001], compared to those with probable asthma. Children with a family history of asthma were more timely to be diagnosed with asthma (HR 1.36, 95% CI: 1.03–1.8, P = 0.031). Children with exercise-induced wheezing or bronchospasm were more timely to be diagnosed with asthma (HR 1.79, 95% CI: 0.95–3.36, P = 0.07), compared to those with spasmodic (or bronchospastic) cough.
Conclusions: Many asthmatic children are not diagnosed with asthma in a timely manner, especially in those without the commonly recognized factors associated with asthma. Health care providers need to be reminded that asthma can still occur in those without commonly recognized risk factors. Asthma guidelines need to emphasize this aspect.