Diagnostic Criteria in Asthma & COPD
Respiratory symptoms of cough, wheeze and shortness of breath are common to many respiratory conditions and can pose a challenge to health care professionals when making a diagnosis. In practice, asthma and Chronic Obstructive Pulmonary Disease (COPD) are the two most commonly confused respiratory conditions. There is no single diagnostic test that can conclusively detect either condition. Detailed history taking, which looks at the presence of predisposing or risk factors for different diseases, and the type, severity and pattern of symptoms is essential in establishing the most likely diagnosis. Appropriate use of objective tests such as spirometry or peak flow to measure lung function may then be used to help confirm or refute the potential diagnosis.
British and international guidelines for asthma and COPD reinforce the importance of clinical judgement based on a detailed history and supported by objective measurements of lung function in making a diagnosis and excluding other pathologies, although draft guidance from NICE puts more emphasis on obective tests than on the history, and recommends spirometry as the first line investigation.
This resource, which is based on a typical case scenario, is offered at an intermediate level and includes five assessment questions to support your continuing professional development. Complete the resource to obtain a certificate for one hour of continuing professional development to include in your annual portfolio.
Aims and Objectives
On completion of this resource you should have an understanding of:
Practice Nurse featured articles
The respiratory year in review Beverley Bostock-Cox
Setting a new benchmark for asthma care Tricia Smith
Improving long-term outcomes in asthma Mandy Galloway
COPD: Prevention, screening and case finding Rachel Booker
Spirometry: Getting the test right Rachel Booker
British Thoracic Society/Scottish IntercollegiateGuidelines Network British Guideline on the Management of Asthma, 2014 http://www.sign.ac.uk/pdf/SIGN141.pdf
NICE CG101. Chronic obstructive pulmonary disease: Management of chronic obstructive pulmonary disease in adults in primary and secondary care: Update guideline, 2010. www.nice.org.uk/cg101
Department of Health. An outcomes strategy for Chronic Obstructive Pulmonary Disease (COPD) and Asthma in England, 2011 www.gov.uk/government/publications/an-outcomes-strategy-for-people-with-chronic-obstructive-pulmonary-disease-copd-and-asthma-in-england
NICE. National Clinical Guideline Centre. Asthma: diagnosis and monitoring of asthma in adults, children and young people. Clinical guideline (Draft), January 2015 https://www.nice.org.uk/guidance/gid-cgwave0640/resources/asthma-diagnosis-and-monitoring-draft-guideline2
Primary Care Commissioning. A guide to quality assured diagnostic spirometry, 2013. http://www.pcc-cic.org.uk/article/guide-quality-assured-diagnostic-spirometry
Further education and training
Differential diagnosis for asthma and COPD forms part of all asthma and COPD diploma and degree level courses in addition to one day workshops provided by Education for Health. For further information please see:
Asthma eLearning Diploma Module (Stirling)
Asthma eLearning Diploma Module (London)
COPD eLearning Diploma Module (Stirling)
Date of preparation: February 2014
Review date: February 2015