TY - JOUR
T1 - An undetected burden of asthma in Italy
T2 - The relationship between clinical and epidemiological diagnosis of asthma
AU - De Marco, R.
AU - Cerveri, I.
AU - Bugiani, M.
AU - Ferrari, M.
AU - Verlato, G.
PY - 1998
Y1 - 1998
N2 - This study aimed to compare questions and tests used in asthma epidemiology with clinical diagnosis of current asthma and to assess the extent of undiagnosed asthma in Italy. Thus, 811 attenders to the second stage of the European Community Respiratory Health Survey were classified by panels of respiratory physicians as current asthmatics or not. Among those with a clinical diagnosis of asthma (n=105), 69% reported current wheezing and 68% asthma with their lifetime (ever asthma), while asthma attacks in the previous year and/or current treatment for asthma (self-reported current asthma) were mentioned by only 37%. Thirty two per cent did not mention asthma at any time, but nevertheless presented a rate of hospitalization close to that of people with self-reported current asthma. On the hand, almost no subjects labelled nonasthmatics by clinicians (n=706) presented self-reported current asthma (5%) or current wheezing (9%). A model simulation showed that, in its usual range (0-15%), asthma prevalence is markedly overestimated by the question on wheezing and underestimated by the questions of self-reported current asthma, with respect to clinical judgement. Prevalence estimates close to those obtained by clinical judgement where achieve by combining asthma-like symptoms in the previous year with the results of lung function and allergological tests, but especially by using the single questions on ever asthma. In conclusion, the present results suggest that the question on ever asthma gives prevalence estimates close to those obtained by clinical judgement and that asthma is greatly underdiagnosed in Italy.
AB - This study aimed to compare questions and tests used in asthma epidemiology with clinical diagnosis of current asthma and to assess the extent of undiagnosed asthma in Italy. Thus, 811 attenders to the second stage of the European Community Respiratory Health Survey were classified by panels of respiratory physicians as current asthmatics or not. Among those with a clinical diagnosis of asthma (n=105), 69% reported current wheezing and 68% asthma with their lifetime (ever asthma), while asthma attacks in the previous year and/or current treatment for asthma (self-reported current asthma) were mentioned by only 37%. Thirty two per cent did not mention asthma at any time, but nevertheless presented a rate of hospitalization close to that of people with self-reported current asthma. On the hand, almost no subjects labelled nonasthmatics by clinicians (n=706) presented self-reported current asthma (5%) or current wheezing (9%). A model simulation showed that, in its usual range (0-15%), asthma prevalence is markedly overestimated by the question on wheezing and underestimated by the questions of self-reported current asthma, with respect to clinical judgement. Prevalence estimates close to those obtained by clinical judgement where achieve by combining asthma-like symptoms in the previous year with the results of lung function and allergological tests, but especially by using the single questions on ever asthma. In conclusion, the present results suggest that the question on ever asthma gives prevalence estimates close to those obtained by clinical judgement and that asthma is greatly underdiagnosed in Italy.
KW - Asthma
KW - Epidemiology
KW - Italy
KW - Physician diagnosis
KW - Treatment
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M3 - Article
C2 - 9596109
AN - SCOPUS:0031954738
VL - 11
SP - 599
EP - 605
JO - European Journal of Respiratory Diseases
JF - European Journal of Respiratory Diseases
SN - 0903-1936
IS - 3
ER -