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Will recording of lung function fluctuation open the door to internet-guided treatment of asthma?
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  1. Maciej Kupczyk*,
  2. Sven-Erik Dahlén
  1. The Unit for Experimental Asthma and Allergy Research, The National Institute of Environmental Medicine and The Centre for Allergy Research at Karolinska Institutet, Stockholm, Sweden
  1. Correspondence to Professor Sven-Erik Dahlén, The Unit for Experimental Asthma and Allergy Research, The National Institute of Environmental Medicine, P O Box 287, Karolinska Institutet, Stockolm SE-117 77, Sweden; sven-erik.dahlen{at}ki.se

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Asthma is a heterogeneous and variable chronic disease. Although it is very common, affecting more than 5% of adults and 10% of children in most parts of the world, asthma remains a great challenge both with respect to proper diagnosis and the means proactively to adjust treatment in a disease that is characterised by periods of worsening and remissions. The diagnostic difficulties are mirrored in the complex definition of asthma which comprises four domains: airway obstruction, symptoms, airway inflammation and airway hyper-responsiveness.1 None of these domains alone is sufficient for diagnosis but together they describe the clinical and pathophysiological face of the syndrome of asthma. Nowadays it is widely accepted that the main goal of asthma treatment is to reach and maintain good control of the disease and, in particular, to prevent and limit periods of flare-ups. In order to improve treatment there is a great need to provide the doctor with a better objective understanding of the level of disease control over time during the patient's daily activities rather than only judging from history and examinations at a visit to the clinic. There is also a desire to find ways to give patients more effective support for self-management, as asthma is a disease where environmental triggers and lifestyle factors play a significant part. Taken together, asthma is the perfect case for internet-governed personalised medicine. It remains, however, to implement this vision because sufficiently sensitive and specific measures have not been established.

In previous editions of the Global Initiative for Asthma (GINA) recommendations for asthma treatment, strong emphasis was placed on lung function measurement. Recording of forced expiratory volume in 1 s (FEV1) and peak expiratory flow …

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