南澳大利亚州哮喘诊断不足的情况。
Underdiagnosed asthma in South Australia.
作者信息
Adams R J, Wilson D H, Appleton S, Taylor A, Dal Grande E, Chittleborough C R, Ruffin R E
机构信息
The Health Observatory, The Queen Elizabeth Hospital, University of Adelaide, Woodville, South Australia.
出版信息
Thorax. 2003 Oct;58(10):846-50. doi: 10.1136/thorax.58.10.846.
BACKGROUND
The prevalence of undiagnosed asthma in the general population and the clinical and demographic characteristics of these patients compared with those with diagnosed asthma are unclear.
METHODS
The North West Adelaide Health Survey (NWAHS) is a population household interview survey of adults (age>18 years) in the north western suburbs of Adelaide, South Australia (regional population 0.6 million). Data obtained were weighted to the closest census data to provide population representative estimates. Positive answers to: "Have you ever had asthma?"; "Has it been confirmed by a doctor?"; "Do you still have asthma?" determined current physician diagnosed asthma. A positive bronchodilator response on spirometric testing according to ATS criteria without a physician's diagnosis determined undiagnosed asthma. Other measures included the SF-12 health survey questionnaire, the Selim index of severity of chronic lung disease, skin allergy tests, and demographic data.
RESULTS
Of the 3422 individuals interviewed, 2523 (74%) agreed to participate in the clinical assessment. Of these, 292 (11.6%) had asthma, 236 (9.3%) with a doctor's diagnosis of asthma and 56 (2.3%) with undiagnosed asthma defined on spirometric criteria; thus, 19.2% of the total asthma group were undiagnosed. Those undiagnosed were more likely (p<0.05) to be >40 years old, on government benefits, with an income <AUD$40,000. Symptom frequency was similar in the two asthma groups, but mean spirometric values were lower in the undiagnosed group (p<0.05) while positive skin allergy tests were more common in the diagnosed group (p<0.05). SF-12 component summary scores were significantly lower in both asthma groups than in the non-asthma population. Undiagnosed asthma was frequent in men and in those aged >65 years. Health service use over the previous year was similar for both asthma groups.
CONCLUSION
Undiagnosed asthma is common among the Australian population, with a similar clinical spectrum to those with diagnosed asthma.
背景
普通人群中未诊断哮喘的患病率以及与已诊断哮喘患者相比这些患者的临床和人口统计学特征尚不清楚。
方法
西北阿德莱德健康调查（NWAHS）是对南澳大利亚阿德莱德西郊成年人（年龄>18岁）进行的人口家庭访谈调查（区域人口60万）。所获数据根据最接近的人口普查数据进行加权，以提供具有人口代表性的估计值。对以下问题的肯定回答：“你曾经患过哮喘吗？”；“是否已由医生确诊？”；“你现在仍患有哮喘吗？”确定当前医生诊断的哮喘。根据美国胸科学会（ATS）标准，在没有医生诊断的情况下，肺功能测试中支气管扩张剂反应呈阳性确定为未诊断哮喘。其他测量指标包括SF - 12健康调查问卷、慢性肺病严重程度的塞利姆指数、皮肤过敏测试和人口统计学数据。
结果
在接受访谈的3422人中，2523人（74%）同意参与临床评估。其中，292人（11.6%）患有哮喘，236人（9.3%）经医生诊断为哮喘，56人（2.3%）根据肺功能标准定义为未诊断哮喘；因此，哮喘总人群中有19.2%未被诊断。那些未被诊断的人更有可能（p<0.05）年龄>40岁、领取政府福利、收入低于40000澳元。两个哮喘组的症状频率相似，但未诊断组的平均肺功能值较低（p<0.05），而确诊组皮肤过敏测试呈阳性更为常见（p<0.05）。两个哮喘组的SF - 12分量表汇总得分均显著低于非哮喘人群。未诊断哮喘在男性和65岁以上人群中很常见。两个哮喘组上一年的医疗服务使用情况相似。
结论
未诊断哮喘在澳大利亚人群中很常见，其临床谱与已诊断哮喘患者相似。
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