Symptoms in Physician-Diagnosed Asthma: Differentiating Factors in Asthma Versus Non-Asthma Diagnoses

Asthma is characterised by symptoms such as shortness of breath, wheeze and cough. However, not all patients with these symptoms have asthma. To develop a pre-test probability to interpret other tests we assessed the symptoms of patients with a physician diagnosis of asthma who were formally diagnosed with or without asthma. In a prospective cohort study of patients referred with suspected asthma. Patients were assessed four times over 3 months. Assessment included symptoms, lung physiology and T2 biomarkers, while between visits ICS treatment use and peak flow were measured digitally. Of 100 patients, 54 (54%) were diagnosed with asthma as per ERS guidelines. The primary cause for the presenting symptoms included asthma (50), allergic rhinitis (14), bronchitis (12), GERD (7), chronic NAR (7) and other (15). Age, BMI and smoking history did not differ significantly between the two groups. Both groups had poorly controlled symptoms at visit 1. <table-wrap><object-id>erj;64/suppl_68/PA4001/T1</object-id><object-id>T1</object-id><object-id>t1</object-id><table><colgroup><col></col><col></col><col></col><col></col></colgroup><tbody><tr><td></td><td>Asthma</td><td>Non-Asthma</td><td>p-value</td></tr><tr><td><italic>Symptoms</italic></td><td></td><td></td><td></td></tr><tr><td>Cough</td><td>41 (75.9)</td><td>36 (81.8)</td><td>0.480</td></tr><tr><td>Dyspnoea</td><td>48(88.8)</td><td>29 (65.9)</td><td><bold><0.05</bold></td></tr><tr><td>Chest tightness</td><td>34 (62.9)</td><td>27(61.3)</td><td>0.871</td></tr><tr><td>Wheeze</td><td>46 (85.1)</td><td>27 (61.3)</td><td><bold><0.05</bold></td></tr><tr><td><italic>Control</italic></td><td></td><td></td><td></td></tr><tr><td>ACT (V1)</td><td>16.22 (4.44)</td><td>18.13 (4.86)</td><td> <bold><0.05</bold> </td></tr><tr><td> Exacerbation (12m) </td><td>33 (61.1)</td><td>24 (54.5)</td><td>0.233</td></tr><tr><td> <bold>Phenotype</bold> </td><td></td><td></td><td></td></tr><tr><td>FeNO (V1)</td><td>29 (31.5)</td><td>15.5 (9.25)</td><td> <bold><0.05</bold> </td></tr><tr><td> Blood eosinophil count </td><td>0.32 (0.19)</td><td>0.19 (0.11)</td><td><bold><0.05</bold></td></tr><tr><td> <italic>Lung function</italic> </td><td></td><td></td><td></td></tr><tr><td> Pre-FEV1/FVC (V1) </td><td>0.75 (0.14)</td><td>0.81 (0.08)</td><td><bold><0.05</bold></td></tr></tbody></table></table-wrap> n (%); Mean (SD); Median (IQR) These data indicate that certain symptoms are more likely to be present in patients with asthma. Future studies clustering symptom features may be used as pre-test probability scores to increase the diagnostic accuracy of tests used to diagnose asthma.