HMN 2025: How Six in 10 children with asthma meet guideline diagnostic criteria

Roughly two-thirds of children with pediatrician-diagnosed asthma have a confirmed diagnosis in accordance with international guideline criteria requiring two or more positive objective tests, according to a study published online Aug. 8 in Pediatric Pulmonology.

Marie Hauerslev, from the University of Copenhagen in Denmark, and colleagues investigated the real-life impact on asthma disease progression and treatment adherence by applying diagnostic criteria from international guidelines (two or more positive tests). The analysis included 115 children (ages 5 to 17 years) with five years of follow-up.

The researchers found that 63% of children had a guideline-confirmed diagnosis in a two-year diagnostic period. While all children had improvements in lung function, those with a guideline-confirmed diagnosis had a higher increase in forced expiratory volume in one second percent-predicted per year (beta-coefficient: 5.4 versus 3.7 for those without a guideline-confirmed diagnosis). The risk for acute asthma events was higher in children with versus without a guideline-confirmed diagnosis (incident rate ratio, 4.7), as was the risk for hospitalization (10 versus one event) and oral corticosteroid treatment (odds ratio, 6.0). There was no association seen between treatment adherence and guideline-confirmed diagnosis or between time to guideline-confirmed diagnosis and disease progression.

“Objective tests are important for diagnosing asthma, as children with ??2 positive tests exhibited more acute events and greater benefit from treatment,” the authors write. “However, improved lung function and acute events also occurred in children with asthma.”

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