Clinical diagnoses of asthma and reactive airway disease (RAD) in young children are subjective. We examined how often children were diagnosed with asthma versus RAD, and whether preventive care and 2-year clinical outcomes differed based on initial diagnosis. We conducted a retrospective cohort analysis of children (2–7 years) from a university-based general pediatrics practice who had been diagnosed with RAD or asthma. We performed adjusted comparisons between groups for time until subsequent asthma-related care. We also compared delivery of asthma-related healthcare services, corticosteroid and controller prescriptions, and action plans within 2 years of index diagnosis, using bivariate and regression analyses. Four hundred three children were included (64% male, 67% Black, 25% Hispanic). RAD was diagnosed in 62% of index visits, and was more likely than asthma to be diagnosed in emergency settings. In the full sample, the time between index visit and subsequent asthma care did not differ between groups, after adjustment for index location. For subjects with complete 24-month follow-up (N = 300), no between-group differences were found in adjusted analyses. Most children with RAD received action plans and controller medications only after a subsequent asthma diagnosis, on average, 9 months after their index visit. RAD diagnoses were linked to delayed delivery of preventive care measures, but within 2 years of initial diagnosis, clinical outcomes for those diagnosed with RAD and asthma did not differ. To facilitate clear communication and timely treatment, a prompt diagnosis of asthma, rather than RAD, should be considered for children with asthma symptoms.

中文翻译：

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诊断为哮喘与反应性气道疾病的幼儿的临床结果

幼儿哮喘和反应性气道疾病 (RAD) 的临床诊断是主观的。我们研究了儿童被诊断出哮喘与 RAD 的频率，以及预防性护理和 2 年临床结果是否因初始诊断而异。我们对来自大学普通儿科诊所的被诊断患有 RAD 或哮喘的儿童（2-7 岁）进行了回顾性队列分析。我们对各组之间的时间进行了调整比较，直到随后进行哮喘相关护理。我们还使用双变量和回归分析比较了哮喘相关医疗保健服务的提供、皮质类固醇和控制器处方以及指数诊断后 2 年内的行动计划。其中包括 403 名儿童（64% 为男性，67% 为黑人，25% 为西班牙裔）。62% 的首次就诊中诊断出 RAD，并且在紧急情况下诊断出 RAD 的可能性高于哮喘。在完整样本中，调整索引位置后，组间索引访问和随后的哮喘护理之间的时间没有差异。对于完成 24 个月随访的受试者 (N = 300)，调整分析中未发现组间差异。大多数患有 RAD 的儿童仅在随后的哮喘诊断后（平均在初次就诊 9 个月后）才接受行动计划和控制药物。RAD 诊断与预防性护理措施的延迟实施有关，但在初次诊断后 2 年内，诊断为 RAD 和哮喘的患者的临床结果没有差异。为了促进清晰的沟通和及时的治疗，对于有哮喘症状的儿童，应考虑立即诊断为哮喘，而不是 RAD。