title: Variability in the labeling of asthma among pediatricians.
abstract: OBJECTIVE
  Few studies have examined variability among physicians in the perception and interpretation of asthma symptoms. We report the results of a pilot study to investigate the variability of symptom description and diagnostic labeling and nomenclature among a group of clinicians using standardized audiovisual presentations of asthma.
  
  
  METHODS
  Practicing pediatricians in Wisconsin recruited from an electronic mailing list were shown the International Study of Asthma and Allergies in Childhood (ISAAC) video questionnaire online, and asked to describe the symptoms and signs they observed and suggest possible diagnostic labels for each presentation.
  
  
  RESULTS
  A total of 113 pediatricians (mean age = 43 years; 56% female) responded to ≥1 of the 5 video scenes. The number of practitioners who described the principal symptom(s) of asthma depicted in the 5 sequences ranged from 5.5% for Scene 5 (featuring both dyspnea and wheeze), to 100% for Scene 4 (featuring cough). The number who suggested label of 'asthma' as a possible cause of the presentations ranged from 69.7% for Scene 3 (featuring nocturnal wheeze), to 92.7% for Scene 2 (featuring exercise induced wheeze).
  
  
  CONCLUSIONS
  There is important unexplained variation in the perceptions and labeling of asthma symptoms among pediatricians. These differences may influence the likelihood of diagnosis and the apparent prevalence of asthma. Many participants suggested that the ISAAC video be used in the education and training of pediatricians.
authors: Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, United States of America. dvansickle@gmail.com
authors: David
authors: D
authors: Van Sickle
authors: Sheryl
authors: S
authors: Magzamen
authors: Matthew J
authors: MJ
authors: Maenner
authors: Julian
authors: J
authors: Crane
authors: Timothy E
authors: TE
authors: Corden
mesh_terms: D000328:Adult; D000368:Aged; D001249:Asthma / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010372:Pediatrics / Q000592:standards; D010820:Physicians / Q000592:standards; D010865:Pilot Projects; D011795:Surveys and Questionnaires; D063189:Symptom Assessment / Q000592:standards; D014741:Video Recording
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