- Initially, decide how likely it is that a person has asthma.
- For children, base this decision on recognizing features that increase or decrease the probability of asthma. For more information, see Probability of asthma in children.
- For adults, base this decision on recognizing features that increase or decrease the probability of asthma and spirometry. For more information, see Probability of asthma in adults.
- Then use clinical judgement to categorize the person into one of three groups:
- High probability: diagnosis of asthma likely.
- Intermediate probability: diagnosis uncertain and insufficient evidence at first consultation to make a firm diagnosis, but no features to support an alternative diagnosis.
- Low probability: diagnosis other than asthma likely.
- For people with an intermediate and high probability of asthma, manage as suspected asthma (to confirm or refute the diagnosis). For more information, see Scenario: New presentation of asthma FIX LINK!!!.
- For people with a low probability of asthma consider an alternative diagnosis.
- Occupational asthma is diagnosed when the diagnosis of asthma is confirmed, the relationship between asthma and work exposure is made, and a specific cause is identified.
- Exercise-induced asthma is usually diagnosed based on symptoms related to exercise.
- People with exercise-induced asthma report symptoms such as coughing and wheezing after 5–10 minutes of exercise or for up to 1–2 hours after finishing exercise. The symptoms are generally worse when breathing cold or dry air (outdoors), or with longer duration or higher intensity of exercise.
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