THE DIAGNOSIS AND INITIAL TREATMENT OF ASTHMA IN YOUNG-CHILDREN IN NEW-ZEALAND AND THE UNITED-KINGDOM

Aims, To conduct a pilot study to test methodology in ascertaining if there are differences between New Zealand and the UK in the symptom an d circumstance set that influences a general practitioner in the initi al diagnosis of asthma, and to ascertain the treatment prescribed at t he time that the diagnosis is made. Methods. Questionnaires were maile d to 110 general practitioners in each country. General practitioners from the Otago region in New Zealand and from the Nottingham region in Britain were contacted. A follow-up reminder was sent to all non-resp onders three weeks after the initial mail out. Questions were asked ab out the symptoms and signs that were considered important, as well as other influences (eg, passive smoking) when making a diagnosis of asth ma in a child under the age of five years. The doctors were also asked what treatment they prescribed at the time of the actual diagnosis of asthma. Results. British doctors considered night cough (p=0.05) and cough associated with emotion (p=0,004) more diagnostic of asthma. New Zealand doctors rated cough associated with temperature change (p=0.0 5) as being important and they had a lower threshold in diagnosing ast hma with respect to history of similar attacks (p=0.008) compared to t heir British counterparts. More New Zealand doctors reported using pro phylactic/anti-inflammatory agents as first line therapy (59% vs 28%; p=0.002). Conclusions, We conclude that there are only minor differenc es in general practitioners' diagnostic criteria for asthma in the two countries with reference to this small sample. We believe, however, t hat differing diagnostic criteria could account for different reported incidences of childhood asthma in some countries. There is need for i nternationally accepted diagnostic criteria.