ReviewBMJ open2020
Defining high probability when making a diagnosis of asthma in primary care: mixed-methods consensus workshop.
Review in BMJ open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
3 citing papers in PubMed.
- Development and validation of a machine learning risk prediction model for asthma attacks in adults in primary care.NPJ primary care respiratory medicine · 2025Article
- Patient views on asthma diagnosis and how a clinical decision support system could help: A qualitative study.Health expectations : an international journal of public participation in health care and health policy · 2023Article
- Deriving and validating an asthma diagnosis prediction model for children and young people in primary care.Wellcome open research · 2023Article
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
objectiveMaking the diagnosis of asthma is challenging. Guidelines recommend that clinicians identify a group at 'high probability' of asthma. High probability, however, is not numerically defined giving rise to uncertainty. The aim of this work was to build consensus on what constitutes a high probability of asthma in primary care. High probability was defined as the probability threshold at which there is enough information to make a firm diagnosis of asthma, and a subsequent negative test would not alter that opinion (assumed to be a false negative).
designMixed-methods study.
settingA consensus workshop using modified nominal group technique was held during an international respiratory conference.
participantsInternational conference attendees eligible if they had knowledge/experience of working in primary care, respiratory medicine and spoke English.
methodsParticipants took part in facilitated discussions and voted over three rounds on what constituted a high probability of asthma diagnosis. The workshop was audio-recorded, transcribed and qualitatively analysed.
resultsBased on final votes, the mean value for a high probability of asthma in primary care was 75% (SD 7.6), representing a perceived trade-off between limiting the number of false positives (more likely if a lower threshold was used) and pragmatism on the basis that first-line preventive therapies (ie, low-dose inhaled corticosteroids) are relatively low risk. The need to review response to treatment was strongly emphasised for detecting non-responders and reviewing the diagnosis.
conclusionA consensus probability of 75% was the threshold at which the primary care participants in this workshop felt confident to establish the diagnosis of asthma, albeit with the caveat that a review of treatment response was essential. Contextual factors, including availability and timing of tests and the ease with which patients could be reviewed, influenced participants' decision making.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.