Asthma and viral bronchiolitis can also be nearly identical to each other when presented in very young children, since they both consist of wheezing, coughing, and nasal congestion. In addition, typical tests used to accurately diagnose children with asthma, such as the bronchial challenge test, are not considered to be accurate for children under the age of five. This can be due to failure of very young children to cooperate. Diagnosing a child with asthma also carries a certain negative connotation, causing hesitancy from some physicians to do so. All of these factors lead physicians to label young children with RAD instead of asthma, since the disease is often only suspected and unable to be confirmed with pediatric patients.Physicians will generally label an adult with RAD if they have no prior diagnosis or history of asthma while exhibiting symptoms of wheezing, production of sputum, and/or the use of an inhaler. Symptoms may also include, but are not limited to, coughing, shortness of breath, excess mucus in the bronchial tube, swollen mucous membrane in the bronchial tube, and/or hypersensitive bronchial tubes. In order to make a formal asthma diagnosis in adult patients, there is requirement to have documentation of either airway hyperreactivity or some sort of reversible airway obstruction. If none of these symptoms are present in an adult patients medical history or documentation, the physician may label the patient with RAD instead of asthma in order to still indicate there is an airway issue without formal diagnosis.
This is a troubling issue for many physicians, as care can be made more complicated; many patients labeled with RAD do not ultimately have asthma and most RAD patients have never formally had their airway reactivity measured.In addition to the inconsistencies of its labeling, there is also no billing designation for RAD in the International Statistical Classification of Diseases and Related Health Problems, or the ICD, which can lead to problems for healthcare facilities. Searches in the ICD, point to content relating to asthma. Some medical professionals argue that using RAD as a diagnosis will only complicate research on asthma in the context of clinical research and epidemiology. There is also dispute that by giving physicians the ability to label a patient with RAD, it gives them a fabricated sense of security that they have made a diagnosis, when no real recognizable diagnosis has been concluded. See also
Bronchiolitis

References


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