Differences Found in Approach to Asthma Treatment

7/12/2006

COLUMBUS, Ohio – New research shows that differences in diagnostic testing for asthma among pulmonologists and family physicians may lead to inaccurate or missed diagnoses.

The study in the Journal of Asthma suggests that pulmonologists are much more likely to order special testing than family physicians when exercise-induced asthma is suspected, according to Dr. Jonathan Parsons, a pulmonologist at Ohio State University Medical Center and lead author of the study.

The findings, drawn from a survey of 500 physicians, concluded that family physicians are much less likely to use objective methods for diagnosing exercise-induced asthma (EIA) than pulmonologists, which may be due to pulmonologists having more access to equipment needed for diagnostic testing. “This difference may lead to inaccurate or missed diagnoses and unnecessary morbidity,” says Parsons.

EIA describes airway narrowing bronchoconstriction that occurs in association with exercise. EIA occurs in up to 90 percent of asthmatics and can also occur in people who do not have asthma at any other time. EIA is estimated to occur in more than 10 percent of the general population without chronic asthma.

“EIA is not accurately diagnosed solely on a patient’s symptom history, and if it is suspected, objective testing should be performed to confirm the diagnosis,” said Parsons. “There are other diseases that have similar symptoms to EIA that could easily be missed if a patient’s symptoms are attributed to EIA without diagnostic confirmation.”

The respondents of the survey included 60 family medicine physicians and 108 physicians who are members of the American Thoracic Society, a group composed primarily of physicians who specialize in pulmonary and/or critical care medicine.

The study’s authors noted that, given the data on the effect of differences in management of asthma between specialists and generalists, additional research is necessary to determine why there are differences and how these differences affect patient outcomes.

“We all need to be educated about best medical practices and standard of care. We all have room for improvement,” Parsons says.

Along with Parsons, other Ohio State researchers involved in the study were James O’Brien, Maria Lucarelli and John Mastronarde.

Funding from The Chest Foundation, which is a part of the American College of Chest Physicians, and a grant from the National Institutes of Health, supported this research.