The effect of symptom presentation on delay in asthma diagnosis in children in a general practice.

Analysis of 187 children diagnosed as having asthma since 1984 in a general practice population is described. Reasons were sought for possible delay in diagnosis so that appropriate steps could subsequently be taken to minimize further delay. Even in an asthma aware practice (original prevalence 8.8%) a delay of approximately 40% of the total age of the child at diagnosis is shown. This delay does not appear to diminish even for children up to 10 years of age. Asthma is more likely to be missed or labelled as 'bronchitis' in children who cough repeatedly, rather than those who wheeze occasionally. As many as 45% of asthmatic children may have had 'bronchitis' diagnosed and treated instead of asthma, so that a diagnosis of repeated 'bronchitis' merely detracts from underlying asthma.