CMAJ • November 18, 2008; 179 (11). doi:10.1503/cmaj.081332.
© 2008 Canadian Medical Association or its licensors
All editorial matter in CMAJ represents the opinions of the authors and not necessarily those of the Canadian Medical Association.
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Right arrow Obesity
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Overdiagnosis of asthma in obese and nonobese adults

Shawn D. Aaron, MD, Katherine L. Vandemheen, BScN, Louis-Philippe Boulet, MD, R. Andrew McIvor, MD, J. Mark FitzGerald, MD, Paul Hernandez, MD, Catherine Lemiere, MD, Sat Sharma, MD, Stephen K. Field, MD, Gonzalo G. Alvarez, MD, Robert E. Dales, MD, Steve Doucette, MSc, Dean Fergusson, PhD for the Canadian Respiratory Clinical Research Consortium

From the Ottawa Health Research Institute (Aaron, Vandemheen, Alvarez, Dales, Doucette, Fergusson), University of Ottawa, Ottawa, Ont.; the Centre de recherche (Boulet), Hôpital Laval, Université Laval, Laval, Que.; the Firestone Institute for Respiratory Health (McIvor), McMaster University, Hamilton, Ont.; the Department of Medicine (Fitzgerald), University of British Columbia, Vancouver, BC; the Department of Medicine (Hernandez), Dalhousie University, Halifax, NS; the Department of Medicine (Lemiere), Université de Montréal, Montréal, Que.; the Department of Medicine (Sharma), University of Manitoba, Winnipeg, Man.; and the Department of Medicine (Field), University of Calgary, Calgary, Alta.


Figure 118
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  		Figure 1: Algorithm used for serial testing to confirm or exclude asthma in participants using inhaled corticosteroids or leukotriene receptor antagonists on entry into the study. *Negative result of bronchial challenge test = the dose of methacholine at which the forced expiratory volume in 1 second (FEV1) fell by at least 20% was greater than 8 mg/mL.

 

Figure 218
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  		Figure 2: Selection of participants and study outcomes.

 

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  		Table 1.

 

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  		Table 2.

 

Figure 318
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  		Figure 3: Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for determinants of an overdiagnosis of asthma among obese and nonobese adults in whom asthma had been diagnosed by a physician. Adjustments were made for clinically relevant discriminators such as baseline FEV1, age at diagnosis of asthma, sex and daily use of asthma medication before entering the study.

 

Figure 418
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  		Figure 4: Adjusted ORs and 95% CIs for environmental exposures associated with an overdiagnosis of asthma among obese and nonobese adults in whom asthma had been diagnosed by a physician. Adjustments were made for high-risk occupation (firefighter, farmer, painter, mechanic or construction worker), exposure to fumes, dusts, pets and cigarette smoke.