Brief Review of Global Strategy for Asthma Management and Prevention, Section 1. Subsection on Making the Initial Diagnosis and Commentary on Box 1-2— Reddel 2020

This is a brief audio review. In the article Global Strategy for Asthma Management and Prevention 2020 Update Section 1. Subsection on Making the Initial Diagnosis and Commentary on Box 1-2 published, 2020 by Reddel and Colleagues, The outcomes and key points are as noted: The Global Initiative for Asthma 2020 Guidelines update, attempted to delineate a diagnostice criteria for Asthma. Key points are as follows: 1. The criteria for asthma diagnosis comprises two categorical features: A. The history of respiratory symptoms. B. Confirmation of variable expiratory airflow limitation and excessive variability in lung function based on lung function tests. These specific details are also discuessed as listed: 2. History of respiratory symptoms consistent with asthma are wheezing, shortness of breath, chest tightness, cough, generally there is more than one type of respiratory symptom, intensity and incidence of symptoms vary over time, generally symptoms are worse at night or on waking up, infections make symptoms related to asthma worse, exercise, laughter, allergens, and cold air worsen or incite asthma; 3.When using pulmonary function tests to diagnose asthma, the gernal rule of thumb is that excessive variation in spirometric and pulmonary function test results are more correlated with a diagnosis of asthma. 4. What to look for in airflow studies: A. Bronchodilator responses demonstrating reversibility, short acting beta agonists should be withheld for 4 hours or more, long acting beta agonists for 15 hours or more. B. In children during episodes with Forced expiratory volume 1 second reduction the FEV1/FVC should be reduced to greater than 0.90. C. During pulmonary function tests with bronchodilation, the forced expiratory volume in 1 second should increase to greater than 12% predicted. D. Excessive variability in twice daily peak expiratory flow readings over 2 weeks, with an average daily daily peak expiratory flow variability of >13%, day's highest minus day's lowest divided by the average of the days highes and lowert, averaged over one week. E. Positive exercise challenge test, children have a reduction in the forced expiratory volume 1 second of greater than 12% predicted, or peak expiratory flow greater than 15%. F. Excessive variation in pulmonary function tests of children demonstrated by changes in FEV1>12% or PEF>15% G. Bronchial provocation tests may be performed but no child specific guidelines were given by this organization.

Global Strategy for Asthma Management and Prevention, Section 1. Subsection on Making the Initial Diagnosis and Commentary on Box 1-2 https://ginasthma.org/wp-content/uploads/2020/06/GINA-2020-report_20_06_04-1-wms.pdf