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Changing incidence of respiratory presentations in primary care fact or artefact?
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  1. C R Simpson1,
  2. A J Lee1,
  3. M W Taylor1,
  4. P J Helms2
  1. 1Department of General Practice & Primary Care, The University of Aberdeen, Scotland, UK
  2. 2Department of Child Health, University of Aberdeen, Scotland, UK
  1. Correspondence to:
    Dr C R Simpson
    Department of General Practice & Primary Care, Foresterhill Health Centre, Westburn Road, The University of Aberdeen, Aberdeen AB25 2AY, Scotland, UK; c.simpabdn.ac.uk

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Recently reported declines in asthma morbidity1 may be difficult to interpret as they could reflect not only changes in incidence, but also changing disease severity, patient expectations, healthcare provision, and efficacy of pharmacological management. Indeed, it has been suggested that general practitioners may choose differing diagnostic labels for respiratory disease to justify prescribing medication.2

In view of these apparent inconsistencies, we used 37 practices taking part in the Scottish Continuous Morbidity Recording project (CMR) to determine possible changes in diagnostic fashion. Changes in the yearly age specific incidence (per 1000 population) were ascertained for the recording of diagnoses and symptoms including asthma, wheeze, and other respiratory illnesses including acute …

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