Diagnosis and classification of asthma in adults
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SUMMARY OF PRACTICE POINTS
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LEVEL OF EVIDENCE 
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| Wheeze suggests asthma but is not pathognomonic. |
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| The absence of physical signs does not exclude a diagnosis of asthma. |
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| Look for signs of allergic rhinitis in patients with suspected asthma. |
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| Do not rely on peak flow meters for assessing airflow limitation in the diagnosis of asthma. |
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| Spirometry is the lung function test of choice for diagnosing asthma and for assessing asthma control in response to treatment. |
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| Pay close attention to spirometry technique to ensure you get the most reliable readings. |
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| The absence of acute reversibility of airflow limitation in response to a short-acting bronchodilator does not exclude the diagnosis of asthma. |
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| Chest X-ray should be ordered if the diagnosis is uncertain, if there are symptoms not explained by asthma, and to exclude other conditions. |
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| Challenge tests may help confirm a diagnosis of asthma. These should be performed only in specialist facilities. |
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| Consider allergy testing whenever you diagnose asthma. |
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| Consider referral to a specialist respiratory physician when the diagnosis is uncertain and for patients in whom occupational asthma is suspected. |
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| Assess the severity of underlying asthma at the initial visit in a patient with newly diagnosed asthma, then reassess severity classification and/or asthma control at subsequent reviews. |
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Note: There is no ‘gold standard’ for the diagnosis of asthma.
Content Created (Thursday, 16 November 2006)
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Last Updated ( Thursday, 31 May 2007 )
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