As a summary, this policy statement advocates:

• A diagnosis of asthma is based on the presence of a structured clinical history, clinical examination and a positive trial of treatment (ICS) in pre-school children (under 5 years old).
• In children aged 5 years and over, objective tests should be carried out, ideally fractional exhaled nitric oxide (FeNO) initially and spirometry with bronchodilator reversibility as second line. Peak flow variability and blood eosinophils can be helpful as third- and fourth-line diagnostic tools when used accurately and appropriately.
• Where there are difficulties in accessing objective tests and there is a high probability of asthma, a trial of ICS can be used, with documentation of a positive response using a validated symptom questionnaire such as the paediatric Asthma Control Test (ACT) or the paediatric Asthma Control Questionnaire (ACQ).
• If there is still diagnostic doubt, a referral to secondary care should be made.