The use of a screening questionnaire to identify children with likely asthma

Background: The theory that airway remodelling and possible fixed asthma ma y result from failure to treat asthma airway inflammation highlights the im portance of the early identification of patients with likely asthma. Aim: To identify children with likely asthma whose condition is unknown to the medical services. Study: Postal questionnaire survey. Setting: Children in two general practice populations in 1999. Method: Parents completed the postal questionnaire surveys. Two validated s coring systems were used to identify children with 'likely asthma': first, three or more positive responses to five key question; second, three or mor e positive responses to the same five questions and one more severe symptom (e.g. exercise-induced wheeze). Questionnaire responses were linked to pra ctice records to determine those with a recorded diagnosis of asthma (ever) or of inhaled medication (past 12 months). Results: Using the first scoring system, 22.5% of children were identified as having likely asthma; more than one-third of these (35.1%) had no corrob orative evidence recorded in the practice records. With the second system, 15.5% had likely asthma, a quarter of whom had no corroborative evidence. D epending on the scoring system chosen, between 3.5% and 8% of children in t hese practices had likely asthma but no corroborative evidence in their rec ords. Conclusions: Children identified using either of these scoring systems woul d require full clinical assessment to determine their need for medical inte rvention. These findings have implications for the allocation of health car e resources.