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Type: Journal article
Title: Underdiagnosed asthma in South Australia
Author: Adams, R.
Wilson, D.
Appleton, S.
Taylor, A.
DalGrande, E.
Chittleborough, C.
Ruffin, R.
Citation: Thorax, 2003; 58(10):846-850
Publisher: British Med Journal Publ Group
Issue Date: 2003
ISSN: 0040-6376
Statement of
R J Adams, D H Wilson, S Appleton, A Taylor, E Dal Grande, C R Chittleborough and R E Ruffin
Abstract: Background: The prevalence of undiagnosed asthma in the general population and the clinical and demographic characteristics of these patients compared with those with diagnosed asthma are unclear. Methods: The North West Adelaide Health Survey (NWAHS) is a population household interview survey of adults (age >18 years) in the north western suburbs of Adelaide, South Australia (regional population 0.6 million). Data obtained were weighted to the closest census data to provide population representative estimates. Positive answers to: "Have you ever had asthma?"; "Has it been confirmed by a doctor?"; "Do you still have asthma?" determined current physician diagnosed asthma. A positive bronchodilator response on spirometric testing according to ATS criteria without a physician’s diagnosis determined undiagnosed asthma. Other measures included the SF-12 health survey questionnaire, the Selim index of severity of chronic lung disease, skin allergy tests, and demographic data. Results: Of the 3422 individuals interviewed, 2523 (74%) agreed to participate in the clinical assessment. Of these, 292 (11.6%) had asthma, 236 (9.3%) with a doctor’s diagnosis of asthma and 56 (2.3%) with undiagnosed asthma defined on spirometric criteria; thus, 19.2% of the total asthma group were undiagnosed. Those undiagnosed were more likely (p<0.05) to be >40 years old, on government benefits, with an income <AUD$40 000. Symptom frequency was similar in the two asthma groups, but mean spirometric values were lower in the undiagnosed group (p<0.05) while positive skin allergy tests were more common in the diagnosed group (p<0.05). SF-12 component summary scores were significantly lower in both asthma groups than in the non-asthma population. Undiagnosed asthma was frequent in men and in those aged >65 years. Health service use over the previous year was similar for both asthma groups. Conclusion: Undiagnosed asthma is common among the Australian population, with a similar clinical spectrum to those with diagnosed asthma.
Keywords: Asthma; diagnosis
Description: © 2003 BMJ Publishing Group Ltd & British Thoracic Society
RMID: 0020030001
DOI: 10.1136/thorax.58.10.846
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