Pulmonary Function Testing in the Diagnosis of Asthma A Population Study
Pulmonary Function Testing in the Diagnosis of Asthma A Population Study
复制标题
DOI：
10.1378/chest.11-0831
复制
发表时间：
2012-05-01
期刊：
影响因子：
9.6
通讯作者：
To, Teresa
中科院分区：
文献类型：
--
作者：
Gershon, Andrea S.;Victor, J. Charles;To, Teresa
背景资料：哮喘是一种常见的慢性呼吸系统疾病，其诊断取决于症状和可变气流阻塞或气道高反应性的客观证据。的人谁有客观的肺功能测试的诊断时间和相关因素的比例接受testing.Methods：一项回顾性队列研究进行了使用的所有个人的健康管理数据年龄在7岁及以上的新医生诊断的哮喘生活在加拿大安大略1996年和2007年之间。在围诊断期接受肺功能检测的确定和检查患者的社会人口学和临床factors.Results：只有42.7%（95%CI，42.6%-42.9%）的465,866安大略省新诊断为哮喘接受肺功能检测1年前和2.5年后的诊断时间。在调整后的分析中，7至9岁和70岁以上的人比年轻人更不可能接受检测，收入最低的社区五分之一的人比收入最高的社区五分之一的人更不可能接受检测，看专科医生的人比只看全科医生的人更可能接受检测。在加拿大安大略，不到一半的新医生诊断的哮喘患者在诊断时接受了客观肺功能检查。需要进一步的研究来确定为什么更多的肺功能测试没有被用于诊断哮喘，以及如何克服其适当使用的障碍。胸部2012; 141（5）：1190-1196
Background: Asthma is a common chronic respiratory condition, the diagnosis of which depends on symptoms and objective evidence of variable airflow obstruction or airway hyperresponsiveness. The proportion of people who have had objective pulmonary function testing around the time of diagnosis and factors associated with receiving testing are not well understood.Methods: A retrospective cohort study was conducted using the health administrative data of all individuals aged 7 years and older with newly physician-diagnosed asthma living in Ontario, Canada between 1996 and 2007. Receipt of pulmonary function testing in the peridiagnostic period was determined and examined across patient sociodemographic and clinical factors.Results: Only 42.7% (95% CI, 42.6%-42.9%) of the 465,866 Ontarians newly diagnosed with asthma received pulmonary function testing between 1 year prior and 2.5 years following the time of diagnosis. In adjusted analyses, individuals 7 to 9 years old and those 70 years or older were less likely to receive testing than younger adults, individuals in the lowest neighborhood income quintile were less likely to receive testing than those in the highest, and individuals seeing a medical specialist were more likely to receive testing than those seeing only a general practitioner.Conclusions: Less than one-half of patients with new physician-diagnosed asthma in Ontario, Canada received objective pulmonary function testing around the time of diagnosis. Further study is needed to determine why more pulmonary function testing is not being used to diagnose asthma and how barriers to its appropriate use can be overcome. CHEST 2012; 141(5):1190-1196