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The average time between sIgE screening and asthma diagnosis by the asthma/COPD‐service was 1.84 years (median 0.90 years, maximum 9.5 years). 5 The test was considered positive when a sIgE level of ≥0.35 kU/L was obtained (i.e. The Phadiatop test was performed for sIgE measurements, which includes common aeroallergens (grass pollen, tree pollen, house dust mite, cat dander, dog dander, moulds and weed pollen). However, in a subset of patients sIgE test results were available by combining coded sIgE data with the coded asthma/COPD data.
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Measurement of specific sIgE is not part of the standard assessment within the asthma/COPD-service. 4 Variables obtained during the assessment of the asthma/COPD-service include medical history, Asthma Control Questionnaire (ACQ), Clinical COPD Questionnaire (CCQ) and spirometry. Since 2007, over 19 000 patients have been assessed by this service. The asthma/COPD-service is an electronic service to support general practitioners (GPs) in the diagnosis and treatment of patients with suspicion of obstructive lung disease. sIgE, Specific immunoglobulin E BdR ≥ 12%, Increase in FEV1 of ≥12% and ≥200 mL compared to the FEV1 prior to bronchodilatation ICS, inhaled corticosteroids *Patients examined for diagnoses other than asthma #“Control” patients where the pulmonologist indicated no obstructive lung disease and no asthma or COPD The other group included “control” patients where the pulmonologist indicated no obstructive lung disease and no asthma or COPD and no bronchodilator reversibility (Figure 1).įlow chart patient inclusion. One group included asthma patients with a confirmed pulmonologist diagnosis of asthma and bronchodilator reversibility >12%. Patients (aged 18–45 years and sIgE data available) who were examined for the diagnosis of asthma were included and divided into two groups. According to Dutch regulations, ethical approval was not required because the data were used anonymously. The study population of this retrospective cross‐sectional database study consists of primary care patients, who visited the asthma/COPD‐service for the first time between 20. 3 Therefore, the aim of this study was to investigate the sensitivity, specificity, positive predicted value (PPV) and negative predicted value (NPV) of sIgE to aeroallergens in primary care patients who were diagnosed with asthma confirmed by remote assessment of a pulmonologist in the asthma/COPD‐service and showing clear bronchodilator reversibility. In the Netherlands, measurement of sIgE to aeroallergens in relation to diagnosis of asthma is recommended by the national primary care asthma guideline. 2Ĭurrently, there is a lack of diagnostic accuracy data for sIgE to aeroallergens in relation to the diagnosis of asthma. This statement only applies to sIgE and not to total IgE measurement, which cannot be used as crucial evidence for allergy diagnosis. Since atopy is one of the predisposing factors for asthma, measurement of specific IgE (sIgE) could be of assistance. However, other parameters could also assist in completing the asthma jigsaw. 1 For diagnosing asthma, after careful history taking, lung function testing is considered the most relevant investigation.
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Overdiagnosis and under diagnosis both occur for this lung disease from which around 300 million people suffer world‐wide. Physicians still have great difficulty in diagnosing asthma.