BMJ 1998;317:1078 ( 17 October )

Letters

Identifying asthma and chronic obstructive pulmonary disease in patients with persistent cough

    Why was no control group studied?
    Children with cough alone should not be labelled asthmatic
    Authors' reply

Why was no control group studied?

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

EDITOR---Thiadens et al examined 192 patients presenting to their general practitioner with persistent cough---a common and challenging problem in primary care---and found a high prevalence of asthma (39%) and chronic obstructive pulmonary disease (7%).1 I was disappointed that they did not provide a control group of asymptomatic subjects in the community.

What is the prevalence of abnormal results of pulmonary function tests in their general population? If it is high, with a prevalence approaching the prevalence found in their population of patients with cough, an alternative conclusion might be that asthma and chronic obstructive pulmonary disease are common and not significantly more common in the population of patients with cough. I encourage Thiadens et al to examine their study group further. One issue deserving scrutiny is whether these patients are still coughing after six months. Also, what diagnoses (if any) apply to the remaining (54%) patients with . . . [Full text of this article]
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