Correia de Sousa Jaime, Silva Manuel Luciano, Lobo Filipa Almada, Yaphe John
School of Health Sciences, University of Minho, Braga, Portugal.
Prim Care Respir J. 2010 Dec;19(4):352-7. doi: 10.4104/pcrj.2010.00022.
Asthma is frequently under-diagnosed with a wide variation in incidence rates. We aimed to assess how physicians in a Portuguese sentinel practice network perform using standardised diagnostic criteria.
Patients consulting one of the 43 network physicians with complaints suggestive of asthma were enrolled in the study over a four-year period. Symptom frequency and diagnoses of asthma were tabulated. Diagnostic accuracy was computed by dividing the rate of asthma diagnosis by the true rate using established diagnostic criteria.
Over four years, 43 physicians followed 32,103 patients (128,412 patient-years) and diagnosed asthma in 310. The diagnosis was confirmed in 260 cases, giving a true incidence rate of 2.02/1000/year (95% confidence interval 1.8 to 2.2) and an accuracy of diagnosis of 84%.
Asthma incidence approaches published rates if accepted criteria are used. Educational efforts to ensure more accurate diagnosis may improve outcomes for asthma patients.
哮喘常常诊断不足，发病率差异很大。我们旨在评估葡萄牙哨点医疗网络中的医生如何运用标准化诊断标准开展工作。
在四年时间里，将向43名网络医生之一咨询疑似哮喘症状的患者纳入研究。统计症状出现频率和哮喘诊断情况。通过用哮喘诊断率除以既定诊断标准下的实际发病率来计算诊断准确性。
在四年时间里，43名医生跟踪了32103名患者（128412患者年），诊断出310例哮喘。其中260例诊断得到确诊，实际发病率为每年2.02/1000（95%置信区间1.8至2.2），诊断准确率为84%。
如果采用公认标准，哮喘发病率接近已公布的发病率。为确保更准确诊断而开展的教育工作可能会改善哮喘患者的治疗效果。
