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0:00
Thank you very much for
coming online to listen to
this update on the management of
difficult asthma in
school-aged children.
My name's Andrew Bush.
I'm a Professor of Paediatrics
at Imperial College
and the Royal Brompton Hospital.
0:15
I have no personal or
institutional conflict
of interest with regard
to this presentation.
0:22
The first part of this
talk, what is 'asthma'?
How do we define asthma?
What are we talking about here?
0:30
This is the Lancet Commission,
which I had the honour of
co-chairing with Ian Pavord.
One of the things that
we wanted to do in this
commission was revolutionise
airway disease
and deliver precision medicine.
What does that look like
in the context of asthma?
0:48
What is this thing
called asthma?
Is it airway inflammation?
Is it variable
airflow obstruction?
Is it bronchial
hyper-responsiveness?
A doctor said so?
I was once given an inhaler?
Or what is it?
Now, like the best
children's games,
every answer is correct.
All these definitions are used.
But our contention
is that asthma is
an umbrella term for wheeze,
dyspnoea, chest-tightness,
possibly with extra cough.
It's an umbrella term.
Just as anaemia is
an umbrella term
for low haemoglobin,
and arthritis is
an umbrella term
for hot red painful joints.
'Asthma' is the start,
not the finish of the
diagnostic journey.
If you say to the child,
"You have asthma,"
questions should come back.
What sort of asthma Is it?