30% asthmatics likely mis-tested

Poor testing, mis-diagnosis blamed

Over diagnosis and misdiagnosis of asthma was as high as 30 per cent because, say pulmonologists, the diagnosis is often done without performing the spirometry test that is important to confirm asthma.

Asthma is a chronic inflammatory disease of the airways, making it difficult for air to move in and out of the lungs.

Common clinical presentations that mimic asthma are chronic obstructive pulmonary disease (COPD), which is due to smoking, acid reflux, sleep apnea or snoring, heart diseases, tuberculosis and pneumonia. These can be wrongly diagnosed as asthma.

Dr B. Chaithanya, consultant pulmonologist and intensivist, explained, “In India the common notion is that wheezing is equal to asthma. More than 40 per cent of wheezing problems are due to various other reasons or underlying ailments, but they are completely misdiagnosed and the patient is put on asthma medications. Thirty per cent of the cases referred to pulmonologists for bronchitis asthma are found to be misdiagnosed.”

Spirometry or pulmonary function test must be carried out to diagnose asthma, but more than 50 per cent of asthmatics are diagnosed without carrying out this test.

“There are various reasons for this,” said Dr Vijay Kumar C, consultant interventional pulmonologist, “like the lack of equipment at many centres and a dearth of qualified technicians to perform the test. There is also lack of knowledge among physicians to interpret the test results, which is a major drawback. There are alternatives like the peak flow meter, which is simple to use and affordable, and which must be insisted upon so that the over diagnosis can be prevented."

Over diagnosis of asthma, and the strong medications that are prescribed as a result, can have major side-effects; patients can develop secondary illness due to these medications.