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首页> 外文期刊>BMC Pulmonary Medicine >Approach to the diagnosis and management of suspected exercise-induced bronchoconstriction by primary care physicians
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Approach to the diagnosis and management of suspected exercise-induced bronchoconstriction by primary care physicians

机译：临床诊断和管理临床运动诱导的初级保健医生诱导的支气管组织

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Background Exercise-related respiratory symptoms in the diagnosis of exercise-induced bronchoconstriction (EIB) have poor predictive value. The aim of this study was to evaluate how athletes presenting with these symptoms are diagnosed and managed in primary care. Methods An electronic survey was distributed to a random selection of family practitioners in England. The survey was designed to assess the frequency with which family practitioners encounter adults with exercise-related respiratory symptoms and how they would approach diagnostic work-up and management. The survey also evaluated awareness of and access to diagnostic tests in this setting and general knowledge of prescribing asthma treatments to competitive athletes. Results 257 family practitioners completed the online survey. One-third of respondents indicated they encountered individuals with this problem at a frequency of more than one case per month. Over two-thirds of family practitioners chose investigation as an initial management strategy, while one-quarter would initiate treatment based on clinical information alone. PEFR pre- and post-exercise was the most commonly selected test for investigation (44%), followed by resting spirometry pre- and post-bronchodilator (35%). Short-acting β2-agonists were the most frequently selected choice of treatment indicated by respondents (90%). Conclusion Family practitioners encounter individuals with exercise-related respiratory symptoms commonly and although objective testing is often employed in diagnostic work-up, the tests most frequently utilised are not the most accurate for diagnosis of EIB. This diagnostic approach may be dictated by the reported lack of access to more precise testing methods, or may reflect a lack of dissemination or awareness of current evidence. Overall the findings have implications both for the management and hence welfare of athletes presenting with this problem to family practitioners and also for the competitive athletes requiring therapeutic use exemption.
机译：背景技术锻炼相关的呼吸系统症状在运动诱导的支气管内（EIB）的诊断中具有差的预测值。本研究的目的是评估竞选这些症状的运动员在初级保健中诊断和管理。方法将电子调查分发到英格兰的家庭从业者随机选择。该调查旨在评估家庭从业者遇到与与运动相关的呼吸系统症状的成年人的频率以及如何接近诊断处理和管理。该调查还评估了对这种环境中的诊断测试的认识和访问诊断测试，以及向竞争运动员规定哮喘治疗的一般知识。结果257家庭从业者完成了在线调查。三分之一的受访者表示，他们每月遇到这个问题的频率超过一个案例。超过三分之二的家庭从业者选择调查作为初始管理策略，而单项将基于临床信息的待遇。 PEFR预和后运动是最常见的调查测试（44％），其次是休息血液计量（35％）。短作用β 2 aiganists是受访者指出的最常选择的治疗选择（90％）。结论家庭从业者遇到具有与运动相关的呼吸系统症状的个体，虽然客观测试通常用于诊断处理，但最常用的测试不是最准确的EIB诊断。这种诊断方法可以通过报告缺乏对更精确的测试方法的访问来规定，或者可能反映出缺乏传播或对当前证据的认识。总体而言，该调查结果对管理和理解对家庭从业者提供了这个问题的管理和理解，以及需要治疗豁免的竞技运动员。

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