Mustafa Ghulam
Pediatric Medicine, College of Medicine Shaqra University, Shaqra, SAU.
Pediatric Medicine, Nishtar Medical University, Multan, PAK.
Cureus. 2022 Sep 30;14(9):e29768. doi: 10.7759/cureus.29768. eCollection 2022 Sep.
There is a lot of disparity in the guidelines and the practice of pediatricians globally for diagnosing asthma in children. To find out if pediatricians are diagnosing asthma in children according to best standard practices.
A cross-sectional study was conducted at tertiary care hospitals' emergency and outpatient departments (OPDs). All the parents accompanying the asthmatic children to the emergency or outpatient departments of the tertiary care hospitals were asked questions regarding the diagnosis of their children's asthma on a prescribed performa. This performa had all the components of the best standard practices for the diagnosis of asthma in children. The data were entered into SPSS version 27 (SPSS Inc., Chicago, IL) and analyzed.
Among the 234 children, the diagnosis of asthma was based on only one component out of three, i.e., recurrence (100%) of symptoms or signs. The objective measurement of the second component, i.e., reversibility with a peak flow meter (PFM) or spirometry, was assessed in only 6% of children. The third component, i.e., the presence of inflammation, was not assessed at all (0.0%).
The diagnosis of asthma in children lacks precision. This is far from the evidence-based best standard practices. There is a need to provide motivation, training, and equipment to the staff.
全球儿科医生在儿童哮喘诊断的指南和实践方面存在很大差异。旨在查明儿科医生是否按照最佳标准做法对儿童哮喘进行诊断。
在三级护理医院的急诊科和门诊部进行了一项横断面研究。所有陪同哮喘儿童前往三级护理医院急诊科或门诊部的家长都被要求在一份规定的表格上回答有关其子女哮喘诊断的问题。该表格包含了儿童哮喘诊断最佳标准做法的所有要素。数据录入SPSS 27版软件（SPSS公司，伊利诺伊州芝加哥）并进行分析。
在234名儿童中，哮喘诊断仅基于三个要素中的一个，即症状或体征的复发（100%）。仅6%的儿童接受了第二个要素的客观测量，即使用峰值流量计（PFM）或肺功能仪进行可逆性评估。第三个要素，即炎症的存在，根本未进行评估（0.0%）。
儿童哮喘的诊断缺乏准确性。这与基于证据的最佳标准做法相差甚远。需要为工作人员提供激励、培训和设备。
