Other problems that healthcare workers have with the use of the RAD label include its exclusion in the International Statistical Classification of Diseases and Related Health Problems, which can lead to billing issues in hospitals and other health care facilities, and the creation of a fabricated sense of security when using it has a diagnosis.RAD can be confused with reactive airways dysfunction syndrome, an asthma-like disorder that results from high exposure to vapors, fumes, and/or smoke. Unlike RAD, reactive airways dysfunction syndrome is recognized by multiple societies as a real clinical syndrome, including the American Thoracic Society and the American College of Chest Physicians. Terminology
The term reactive airway disease originally began to appear in medical literature in the 1980s in reference to asthmatic patients with hyperactive airways, which is a common feature of asthma. This feature is characterized by increased bronchoconstriction reactions in response to stimuli that should not elicit so strong of response. These stimuli can include methacholine, histamine, and distilled water. However, while this was how the term initially was introduced, RAD soon began to be used interchangeably with the term asthma itself, which has led to the current controversy over its place in medical diagnoses.More commonly, RAD is now mostly used by physicians when they are hesitant to diagnose a patient with asthma. This is most prominent in pediatric settings for a variety of reasons. While infants tend to wheeze more often than adults, only one third of them eventually go on to actually have asthma.
Controversy over use
There remains controversy over the use of RAD as an unofficial diagnosis. With its use not only being limited to clinical lexicon, but also transitioning to clinical literature now, more physicians are now increasingly disapproving its use in the healthcare setting.One of the largest problems with the using RAD as a diagnostic label lies in the ambiguity of its meaning, as RAD has no true clinical definition. It is either not listed or redirects to "asthma" in all major medical journal or website. In addition to that, it is also not recognized in the American Academy of Pediatrics; the American Thoracic Society; or the National Heart Lung and Blood Institute. In addition, treatments for asthma, chronic bronchitis, emphysema, or pneumonia may not be prescribed under a label of reactive airway disease. In contrast, some physicians also fear overtreatment for RAD, as patients can be prescribed inhaled beta-agonists or inhaled corticosteroids, which are medications used for asthma. If an individual with RAD doesnt have asthma, there is no evidence these treatments are beneficial. As a result of its ambiguous place in the medical field, the symptoms used to characterize it are often inconsistent and can lead to confusion in a healthcare setting.