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Mismatch between asthma symptoms and spirometry: implications for managing asthma in children.

Spirometry was performed on 894 children (5-19) in Connecticut in whom clinical assessment had found intermittent asthma in 30% and mild, moderate and severe persistent asthma in 32%, 33% and 5% respectively. Worsening spirometric parameters were associated with more severe clinical disease. But spirometric assessment showed greater disease severity than clinical asessment in 36% and concordance between spirometric results and clinical symptoms was poor, 0.2 after adjustment for bias and prevalence. Asthma morbidity is known to be reduced by appropriate treatment and the authors suggest that spirometry results may be a better guide for therapy decisions than symptomatology.

Schifano ED et al. J Pediatr. 2014 Aug 28. pii: S0022-3476(14)00650-7. doi: 10.1016/j.jpeds.2014.07.026. [Epub ahead of print]

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