MacNeil Jenna, Loves Robyn H, Aaron Shawn D
a Department of Medicine , The Ottawa Hospital Research Institute, University of Ottawa , Ottawa , Canada.
Expert Rev Respir Med. 2016 Nov;10(11):1187-1198. doi: 10.1080/17476348.2016.1242415. Epub 2016 Oct 8.
Asthma is diagnosed based on patients' respiratory symptoms of wheeze, cough, chest tightness and/or dyspnea together with physiologic evidence of variable and reversible expiratory airflow limitation. A high prevalence of overdiagnosis, underdiagnosis and misdiagnosis of adult asthma has been reported in the literature. Areas covered: Misdiagnosis of asthma in adults can occur in the community due to physicians' failure to confirm airflow limitation using spirometry, the relatively poor sensitivity of spirometry to absolutely rule in asthma, the complexity of multiple asthma phenotypes and endotypes, and the inherent day to day variability of asthma symptoms and airflow limitation. Consequences of asthma misdiagnosis to the patient and to the healthcare system include increased medication costs, increased potential side effects related to unnecessary use of medications and lost opportunities to diagnose the true cause of patients' respiratory symptoms. Expert commentary: Here we provide a review of the problem of misdiagnosis of adult asthma and suggestions for how to decrease the risk of misdiagnosis.
哮喘的诊断基于患者出现喘息、咳嗽、胸闷和/或呼吸困难等呼吸道症状，以及存在可变且可逆的呼气气流受限的生理学证据。文献报道成人哮喘存在过度诊断、诊断不足和误诊的高发生率。涵盖领域：成人哮喘的误诊可能发生在社区，原因包括医生未使用肺功能仪确认气流受限、肺功能仪对确诊哮喘的敏感性相对较差、多种哮喘表型和内型的复杂性，以及哮喘症状和气流受限固有的日常变异性。哮喘误诊对患者和医疗系统的后果包括药物成本增加、因不必要用药导致的潜在副作用增加，以及错失诊断患者呼吸道症状真正病因的机会。专家评论：在此，我们对成人哮喘误诊问题进行综述，并就如何降低误诊风险提出建议。
