Asthma Diagnosis and Diagnostic Testing Methods
Summary
Asthma is a heterogeneous respiratory condition characterised by variable airflow obstruction, airway inflammation and bronchial hyperresponsiveness. Accurate diagnosis hinges on combining clinical assessment with objective tests to confirm episodic airflow limitation and underlying inflammation. Key physiological measures include spirometry with bronchodilator reversibility, peak expiratory flow (PEF) variability and bronchial provocation tests using agents such as methacholine or histamine. Non-invasive biomarkers, notably fractional exhaled nitric oxide (FeNO) and peripheral blood eosinophil counts, provide insight into eosinophilic airway inflammation and help to define phenotypes amenable to targeted anti-inflammatory therapy. Diagnostic pathways now emphasise stepwise testing: initial spirometry in all suspected cases, followed by PEF monitoring or challenge testing if baseline lung function appears normal. This approach reduces misdiagnosis, guides personalised treatment and improves long-term outcomes. Practical application varies by setting, with primary care often relying on portable devices and trial of therapy, while specialist centres perform comprehensive lung function and inflammatory profiling.
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Asthma Diagnosis and Diagnostic Testing Methods publication trend
The graph below shows the total number of articles in asthma diagnosis and diagnostic testing methods across all publications each year (not limited to Nature Index journals).
Technical terms
Spirometry: A lung function test measuring volumes and flow rates during forced inhalation and exhalation to identify airflow obstruction and reversibility.
Bronchial challenge test: An inhalational provocation procedure using agents like methacholine or histamine to assess airway hyperresponsiveness.
Fractional exhaled nitric oxide (FeNO): A non-invasive biomarker reflecting eosinophilic airway inflammation, measured in exhaled breath at parts per billion.
Peak expiratory flow (PEF): The maximum flow achieved during a forced exhalation, recorded with a portable metre to monitor variability over time.
References
- Approaches to Asthma Diagnosis in Children and Adults. Frontiers in Pediatrics (2019).
- The use of a direct bronchial challenge test in primary care to diagnose asthma. npj Primary Care Respiratory Medicine (2020).
- Qualitative study of practices and challenges when making a diagnosis of asthma in primary care. npj Primary Care Respiratory Medicine (2019).
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