FAUX ASTHMES

Faux Asthmes : j'avais raison : cf article paru le 1er mars 2016 dans le British Medical Journal etc.
Cf plus loin sur ce blog l'article "sinusite de l'enfant"
Dommage qu'il n'y ait pas plus de visites ici, il y a de bonnes choses, et des vraies !!!!! :o)
Dans l'article ils sont gentils : ils parlent de 50 % de faux asthmes. Moi j'ai compté 80 % sur plus de 1000 ou deux milles dossiers......voire plus.....

23.12.2016 : Erratum
En fait, en relisant ce brillant article Hollandais, on lit que seuls 16 % des asthmes sont confirmés en spirométrie. Cela confirme parfaitement ce que j’écrivais avant en chiffrant les faux asthmes à 80 %.
( j'ai mis en gras ce chiffre de 16 % dans le paragraphe results) . Ce n'est donc pas 50 % (j'avais lu un peu trop vite)

En clair comme en résumé : 84 % des enfants traités pour asthme ne sont pas asthmatiques !
Je confirme, cela correspond EXACTEMENT à mes constatations personnelles sur 25 ans.

J'ai commencé la traduction, mais je bloque sur un mot.... Et depuis je suis en stand by. C'est con, mais je suis comme ça.... :)

abstract/extrait :

Overdiagnosis of asthma in children in primary care: a retrospective analysis

Abstract

Background Asthma is one of the most common chronic diseases in childhood. According to guidelines, a diagnosis of asthma should be confirmed using lung function testing in children aged >6 years. Previous studies indicate that asthma in children is probably overdiagnosed. However, the extent has not previously been assessed.
Aim To assess the extent and characteristics of confirmed and unconfirmed diagnoses of asthma in children who were diagnosed by their GP as having asthma or who were treated as having asthma.
Design and setting Retrospective analysis in four academic primary healthcare centres in Utrecht, the Netherlands.
Method Routine care registration data of children aged 6–18 years who received a diagnosis of asthma or were treated as having asthma were analysed.
Results In only 16.1% (n = 105) of the children diagnosed with asthma was the diagnosis confirmed with spirometry, whereas in 23.2% (n = 151) the signs and symptoms did give rise to suspected asthma but the children should have undergone further lung function tests. In more one-half (53.5%, n = 349) of the children the signs and symptoms made asthma unlikely and thus they were most likely overdiagnosed. The remaining 7.2% (n = 47) were probably correctly classified as not having asthma. The main reasons for classifying asthma without children undergoing further lung function tests were dyspnoea (31.9%, n = 174), cough (26.0%, n = 142), and wheezing (10.4%, n = 57).
Conclusion Overdiagnosis of childhood asthma is common in primary care, leading to unnecessary treatment, disease burden, and impact on quality of life. However, only in a small percentage of children is a diagnosis of asthma confirmed by lung function tests.

Ingrid Looijmans-van den Akker, Karen van Luijn, Theo Verheij

DOI: 10.3399/bjgp16X683965 Published 1 March 2016

• Received June 5, 2015.
• Revision requested August 30, 2015.
• Accepted November 24, 2015.

• © British Journal of General Practice 2016