Episode 18: Adult-Onset Asthma

Su Robotti, Founder of MedShadow, and Jonathan Block, Content Manager, discuss a new study that reveals overdiagnosis of asthma. Is it possible you’ve been misdiagnosed? How would you know? Watch to learn more.

Su Robotti: Hello my name is Su Robotti and I’m the founder of MedShadow.

Jonathan Block: I’m Jonathan Block and I’m the content manager here at MedShadow.

SR: Thanks for joining us. Jonathan and I wanted to bring to your attention a study on adult onset asthma. It seems as perhaps not all the adults who have been diagnosed with asthma, may have asthma or maybe there seems to be a remission rate, and this is important, because right now, asthma is considered a chronic disease. Once diagnosed with asthma, you’ll probably be on medicines for it, or it would be on your medical record for life. Why is that probably, Jonathan?

JB: Well, I’m going to blame it though, first of all, back to these studies that you were talking about that was published in the journal of American Medical Association that found that one in three people that have been diagnosed with asthma actually don’t even have asthma. They’ve been misdiagnosed. Now why is this a problem? Because over diagnoses can lead to unnecessary medical treatment, and as the watchers of MedShadow TV know, all medicines have side effects and you don’t want to take a medicine unless you absolutely have to.

SR: There are two issues at hand here. There could be the issue of over diagnoses and there could be the issue of remission. So first, talk about over diagnoses. There is no definitive tests that says, yes, you have asthma or no you don’t. It’s a nuance disease, a doctor needs to use some judgment on this. There are a couple of standardized testing that can be used. Spirometry…

JB: Spirometry–

SR: Spirometry, and the Vincula challenge or two of them, but the doctor will also consider most importantly your symptoms, your personal history, and your family history, and come to a decision. Quite often, if a patient presents or comes in with wheezing, long-term coughing, chest tightness, the doctor will hand the patient an inhaler, and if that inhaler helps to clear up the wheezing or discomfort immediately, that can end up being the diagnosis. And that is a rushed diagnosis.

JB: About 20 percent of the people that do have asthma, they end up going to remission with asthma, unfortunately, what also happens that even under in remission, they still may continue to take their oral corticosteroid medication.

SR: So our suggestion is that every so often you go back to your doctor, or go to a new doctor, and ask for a re-diagnosis, just to check, do you really have asthma or has it cleared up or maybe you never really had it, new underlying issue is going away on its own. The doctor will probably work with you on a plan on how to figure that. I will say don’t just stop taking medicine, you need to talk to your doctor about this. There were some limits to this study–

JB: Yes, there were. First limit was that the patients that were included were only followed for 50 months, which is anybody that knows anyone that has asthma has a very short period of time to be looked at for asthma. People who have been taking oral corticosteroids for a long period of time were excluded from the study which is key and only about 45 percent of the people included in this trial and the study that involved the trial were actually on an active medication.

SR: If you want more information on asthma or on the corticosteroids, please go to our website at www.medshadow.org where you should find a lot of more information, right Jonathan?

JB: Exactly.

SR: Thank you.

Deirdre Wyeth

Deirdre Wyeth is the Digital Director of MedShadow.org. She has worked as a digital content strategist for almost 20 years. She specializes in web content, usability and SEO. You can learn more here.

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