{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T05:09:56Z","timestamp":1790744996955,"version":"4.1.0"},"reference-count":35,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2020,11,17]],"date-time":"2020-11-17T00:00:00Z","timestamp":1605571200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Pulmonology"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Exercise\u2010induced respiratory symptoms (EIS) are common in childhood and reflect different diseases that can be difficult to diagnose. In children referred to respiratory outpatient clinics for EIS, we compared the diagnosis proposed by the primary care physician with the final diagnosis from the outpatient clinic and described diagnostic tests and treatments.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>An observational study of respiratory outpatients aged 0\u201316 years nested in the Swiss Paediatric Airway Cohort (SPAC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients<\/jats:title>\n                    <jats:p>We included children with EIS as the main reason for referral. Information about diagnostic investigations, final diagnosis, and treatment prescribed came from outpatient records. We included 214 children (mean age 12 years, range 2\u201317, 54% males) referred for EIS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The final diagnosis was asthma in 115 (54%), extrathoracic dysfunctional breathing (DB) in 35 (16%), thoracic DB in 22 (10%), asthma plus DB in 23 (11%), insufficient fitness in 10 (5%), chronic cough in 6 (3%), and other diagnoses in 3 (1%). Final diagnosis differed from referral diagnosis in 115 (54%, 95%\u2010CI 46%\u201360%). Spirometry, body plethysmography, and exhaled nitric oxide were performed in almost all, exercise\u2010challenge tests in a third, and laryngoscopy in none. 91% of the children with a final diagnosis of asthma were prescribed inhaled medication and 50% of children with DB were referred to physiotherapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Diagnosis given at the outpatient clinic often differed from the diagnosis proposed by the referring physician. Diagnostic evaluations, management, and follow\u2010up differed between clinics and diagnostic groups highlighting the need for evidence\u2010based diagnostic guidelines and harmonized procedures for children seen for EIS.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ppul.25126","type":"journal-article","created":{"date-parts":[[2020,10,20]],"date-time":"2020-10-20T11:12:18Z","timestamp":1603192338000},"page":"217-225","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Diagnosis in children with exercise\u2010induced respiratory symptoms: A multi\u2010center study"],"prefix":"10.1002","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0293-9954","authenticated-orcid":false,"given":"Eva S. L.","family":"Pedersen","sequence":"first","affiliation":[{"name":"Institute of Social and Preventive Medicine University of Bern  Bern Switzerland"},{"name":"Graduate School for Health Sciences University of Bern  Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7924-518X","authenticated-orcid":false,"given":"Cristina","family":"Ardura\u2010Garcia","sequence":"additional","affiliation":[{"name":"Institute of Social and Preventive Medicine University of Bern  Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen C. M.","family":"de Jong","sequence":"additional","affiliation":[{"name":"Institute of Social and Preventive Medicine University of Bern  Bern Switzerland"},{"name":"Graduate School for Cellular and Biomedical Sciences University of Bern  Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anja","family":"Jochmann","sequence":"additional","affiliation":[{"name":"Division of Paediatric Pulmonology, University Children's Hospital University of Basel  Basel Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7284-4251","authenticated-orcid":false,"given":"Alexander","family":"Moeller","sequence":"additional","affiliation":[{"name":"Division of Paediatric Pulmonology University Children's Hospital Zurich  Z\u00fcrich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominik","family":"Mueller\u2010Suter","sequence":"additional","affiliation":[{"name":"Division of Paediatric 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