BMJ 1998;317:227-228 ( 25 July )

Editorials

Objective measures and the diagnosis of asthma

We need a simple diagnostic testbut don't yet have one 

The first 150 words of the full text of this article appear below.

Diseases represent extremes of continuously distributed characteristics, and defining exactly where and why in that distribution normality ends and disease begins may be difficult. The use of objective markers can be helpful, but these often force us to change our concept of a disease to accommodate the new information they providesuch as the identification of subclinical disease or adverse prognostic factors in otherwise healthy people. These conceptual changes are part of the natural evolution of disease definition and are justified if, in the long run, patients benefit.

Asthma has always been a clinical diagnosis, recognised on the basis of a characteristic history of variable wheezing, cough, and breathlessness and supported by objective, though non-standardised, evidence of variations in airflow. Many attempts have been made to define this diagnosis. Since 1958¹ all have highlighted the fundamental abnormality of variable airflow obstruction, and some have also invoked concepts such as airway . . . [Full text of this article]

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Clinicians should be proactive in testing for asthma

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Rapid Responses:

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Tension between generalists and specialists

A J Wardlaw
bmj.com, 7 Aug 1998 [Full text]

epidemiological versus clinical assessment of asthma

Henk Thiadens
bmj.com, 3 Sep 1998 [Full text]

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