Respiratory and Allergy Units, Arrixaca University Children's Hospital, University of Murcia & IMIB Research Institute, Murcia, Spain.
Asthma UK, London, UK.
Clin Exp Allergy. 2018 Feb;48(2):104-120. doi: 10.1111/cea.13080.
The diagnosis of asthma is currently based on clinical history, physical examination and lung function, and to date, there are no accurate objective tests either to confirm the diagnosis or to discriminate between different types of asthma. This consensus exercise reviews the state of the art in asthma diagnosis to identify opportunities for future investment based on the likelihood of their successful development, potential for widespread adoption and their perceived impact on asthma patients. Using a two-stage e-Delphi process and a summarizing workshop, a group of European asthma experts including health professionals, researchers, people with asthma and industry representatives ranked the potential impact of research investment in each technique or tool for asthma diagnosis and monitoring. After a systematic review of the literature, 21 statements were extracted and were subject of the two-stage Delphi process. Eleven statements were scored 3 or more and were further discussed and ranked in a face-to-face workshop. The three most important diagnostic/predictive tools ranked were as follows: "New biological markers of asthma (eg genomics, proteomics and metabolomics) as a tool for diagnosis and/or monitoring," "Prediction of future asthma in preschool children with reasonable accuracy" and "Tools to measure volatile organic compounds (VOCs) in exhaled breath."
目前,哮喘的诊断基于临床病史、体格检查和肺功能,迄今为止,尚无准确的客观测试方法可用于确诊或区分不同类型的哮喘。这项共识研究回顾了哮喘诊断的最新技术,旨在根据其成功开发的可能性、广泛采用的潜力以及对哮喘患者的预期影响,确定未来投资的机会。研究人员采用两阶段电子德尔菲法和总结研讨会,召集了包括卫生专业人员、研究人员、哮喘患者和行业代表在内的一组欧洲哮喘专家,对每种哮喘诊断和监测技术或工具的研究投资的潜在影响进行了排名。在对文献进行系统回顾后,提取了 21 条陈述,并对这些陈述进行了两阶段德尔菲法评分。11 条陈述得分为 3 分或以上,并在面对面研讨会上进行了进一步讨论和排名。排名前三的重要诊断/预测工具如下:“哮喘的新型生物标志物(如基因组学、蛋白质组学和代谢组学)作为诊断和/或监测工具”、“以合理的准确度预测学龄前儿童未来的哮喘”和“测量呼气中挥发性有机化合物(VOCs)的工具”。