RAD: Reactive Airways Disease or Really Asthma Disease?

Abstract

* Abbreviation: RAD — : reactive airways disease A resident presenting on rounds introduces her patient as “a 15-month-old with RAD. He’s had 2 days of wheezing, and we started albuterol and steroids.” A presentation like this is frequently heard on pediatric units despite the vagueness of the term “reactive airways disease,” commonly referred to as “RAD.” The term is often used as a substitute for asthma in young children on asthma medications when pediatricians are reticent to use the “A word.” Yet RAD has no accepted definition and does not add any specificity to the medical vocabulary. The reluctance to use the term “asthma” in a patient in whom asthma medications are being administered, no matter the age, is perplexing. In a field whose terminology is extensive enough to constitute its own language, it is surprising that we have allowed such a term to slip into the medical lexicon. Recently, members of the Canadian Thoracic Society Asthma Clinical Assembly partnered with the Canadian Pediatric Society to reevaluate clinical practice surrounding the diagnosis and management of asthma in preschoolers.1 Their position paper asserts that RAD, and other vague and nondiagnostic terms, be abandoned. Accordingly, we call on the analogous pediatric and respiratory societies in the United States and around the world to discourage the continued use of “RAD” across medical settings and … Address correspondence to Lindsey C. Douglas, MD, MS, Department of Pediatrics, The Children’s Hospital at Montefiore, 3415 Bainbridge Ave, Bronx, NY 10467. E-mail: douglas{at}montefiore.org