Seventy asthmatic patients newly referred to a hospital outpatient clinic have been studied. In one-third of the patients the diagnosis of asthma had not been considered. Eight patients presented with an FEV1 of one litre or less. Acute severe asthma is commonly believed to precede death from asthma, but patients with more chronic symptoms may have equally severe airways obstruction without appearing acutely ill. Failure to diagnose and treat such patients may be contributing to our present inability to reduce the death rate from asthma.
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