Are diagnostic labels of asthma, COPD even viable?

A team of researchers has tried to explore whether or not tagging every patient's breathing problem as asthma and chronic obstructive pulmonary disease (COPD) is viable.

Defining a patient's symptoms using the historical diagnostic labels of asthma and COPD is an outdated approach to understanding an individual's condition, according to the experts.

In a perspective article, Professor Alvar Agusti and colleagues call for a new approach to patient management, which moves away from categorising patients using the broad disease terms of asthma and COPD and towards a more personalised approach to management that identifies 'treatable traits' in each patient.

Hospitalisation rates for COPD are continuing to increase and a majority of asthma patients live with significant symptoms, impairing their quality of life. While the labels of asthma and COPD are valuable for patients who display stereotypical symptoms, there are a growing number of patients who do not fit this category, including patients with adult-onset asthma, smoking asthmatics or patients with the so-called asthma-COPD overlap syndrome.

Agusti commented that they propose a label-free precision medicine approach based on treatable traits that categorise the clinical and biological complexity of airway disease. The approach we are suggesting would radicalise healthcare and have significant implications for the organisation of a healthcare system.

He added that by recognising the clinical and biological complexity of a disease, they can use causal mechanistic disease pathways to adopt a more precise approach, which is hopefully more effective at managing patients with these conditions.

Peter Sterk, from the University of Amsterdam, supports the call for a move away from diagnostic labels, saying that we are living in an era where we have new biological knowledge and new targets for therapy but we largely continue to guide patient management with diagnostic labels. It is the right time for healthcare professionals to take bold steps and move aware from historical diagnoses that are impeding modern medicine.

The study appears in the European Respiratory Journal.