Desktop Helper No.15 - The ‘jigsaw puzzle’ approach to building a diagnostic picture of asthma in primary care over time

There is no single objective diagnostic test for asthma. Instead, we suggest an approach of collecting and assembling pieces of clinical information to create a diagnostic picture, like making a jigsaw puzzle. These pieces should include demonstration of symptom and airway variability and/or bronchodilator responsiveness over time, to support a clinical diagnosis. This process becomes easier with experience, as patterns become more recognisable. For those clinicians less confident with diagnosing asthma, this desktop helper demonstrates how to build the picture with the patient over time, ideally involving several scheduled appointments.

Authors: Dermot Ryan, Janwillem Kocks, Jaime Correia de Sousa and Siân Williams on behalf of the expert group

Reviewers: Monica Barne, Izolde Bouloukaki, Antonio G. Caviglia, Luke Daines, Erol Gaillard, Cristina Isar, Vince Mak, Anders Østrem, Kirsten Romberg, Amanda Barnard  

Editor: Tracey Lonergan 

Funding statement: The Asthma Jigsaw Project was jointly funded by the IPCRG, GlaxoSmithKline, AstraZeneca and Vitalograph. Industry sponsors took no part in drafting the Desktop Helper or teaching materials.