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- Title
Overdiagnosis of asthma in obese and nonobese adults.
- Authors
Aaron, Shawn D.; Vandemheen, Katherine L.; Boulet, Louis-Philippe; McIvor, R. Andrew; FitzGerald, J. Mark; Hernandez, Paul; Lemiere, Catherine; Sharma, Sat; Field, Stephen K.; Alvarez, Gonzalo G.; Dales, Robert E.; Doucette, Steve; Fergusso, Dean
- Abstract
Background: It is unclear whether asthma is overdiagnosed in developed countries, particularly among obese individuals, who may be more likely than nonobese people to experience dyspnea. Methods: We conducted a longitudinal study involving nonobese (body mass index 20-25) and obese (body mass index = 30) individuals with asthma that had been diagnosed by a physician. Participants were recruited from 8 Canadian cities by means of random-digit dialing. A diagnosis of current asthma was excluded in those who did not have evidence of acute worsening of asthma symptoms, reversible airflow obstruction or bronchial hyperresponsiveness, despite being weaned off asthma medications. We stopped asthma medications in those in whom a diagnosis of asthma was excluded and assessed their clinical outcomes over 6 months. Results: Of 540 individuals with physician-diagnosed asthma who participated in the study, 496 (242 obese and 254 nonobese) could be conclusively assessed for a diagnosis of asthma. Asthma was ultimately excluded in 31.8% (95% confidence interval [CI] 26.3%-37.9%) in the obese group and in 28.7% (95% CI 23.5%-34.6%) in the nonobese group. Overdiagnosis of asthma was no more likely to occur among obese individuals than among nonobese individuals (p = 0.46). Of those in whom asthma was excluded, 65.5% did not need to take asthma medication or seek health care services because of asthma symptoms during a 6-month follow-up period. Interpretation: About one-third of obese and nonobese individuals with physician-diagnosed asthma did not have asthma when objectively assessed. This finding suggests that, in developed countries such as Canada, asthma is overdiagnosed.
- Subjects
CANADA; ASTHMA diagnosis; OVERWEIGHT persons; ANTIASTHMATIC agents; OBSTRUCTIVE lung diseases
- Publication
Canadian Medical Association Journal (CMAJ), 2008, Vol 179, Issue 11, p1121
- ISSN
0820-3946
- Publication type
Article
- DOI
10.1503/cmaj.081332