Easy diagnosis of asthma: computer-assisted, symptom-based diagnosis.
Diagnosis of asthma is often challenging in primary-care physicians due to lack of tools measuring airway obstruction and variability. Symptom-based diagnosis of asthma utilizing objective diagnostic parameters and appropriate software would be useful in clinical practice. A total of 302 adult patients with respiratory symptoms responded to a questionnaire regarding asthma symptoms and provoking factors. Questions were asked and recorded by physicians into a computer program. A definite diagnosis of asthma was made based on a positive response to methacholine bronchial provocation or bronchodilator response (BDR) testing. Multivariate logistic regression analysis was used to evaluate the significance of questionnaire responses in terms of discriminating asthmatics. Asthmatic patients showed higher total symptom scores than non-asthmatics (mean 5.93 vs. 4.93; p<0.01). Multivariate logistic regression analysis identified that response to questions concerning the following significantly discriminated asthmatics; wheezing with dyspnea, which is aggravated at night, and by exercise, cold air, and upper respiratory infection. Moreover, the presence of these symptoms was found to agree significantly with definite diagnosis of asthma (by kappa statistics). Receiver-operating characteristic curve analysis revealed that the diagnostic accuracy of symptom-based diagnosis was high with an area under the curve of 0.647 +/- 0.033. Using a computer-assisted symptom-based diagnosis program, it is possible to increase the accuracy of diagnosing asthma in general practice, when the facilities required to evaluate airway hyperresponsiveness or BDR are unavailable.
Choi
Byoung Whui
BW
Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea.
Yoo
Kwang-Ha
KH
Jeong
Jae-Won
JW
Yoon
Ho Joo
HJ
Kim
Sang-Heon
SH
Park
Yong-Mean
YM
Kim
Wo-Kyung
WK
Oh
Jae-Won
JW
Rha
Yeong-Ho
YH
Pyun
Bok-Yang
BY
Chang
Suk-Il
SI
Moon
Hee-Bom
HB
Kim
You-Young
YY
Cho
Sang-Heon
SH
D000328:Adult; D001249:Asthma / Q000175:diagnosis* / Q000473:pathology*; D001985:Bronchial Provocation Tests; D001993:Bronchodilator Agents / Q000494:pharmacology; D003936:Diagnosis, Computer-Assisted; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011237:Predictive Value of Tests; D012372:ROC Curve; D012044:Regression Analysis; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires
D001993:Bronchodilator Agents