The Institut für Allgemeinmedizin (Institute of General Practice), part of the Technische Universitat Munchen, hosted me during a gloriously sunny week in June. My visit had been planned for over a year since meeting Professor Antonius Schneider, an expert in asthma diagnostic studies.
My interest in asthma diagnosis developed after helping to update the Scottish Intercollegiate Guideline Network asthma diagnosis chapter. I was surprised to realise the limited evidence available to support current recommendations. Completing a project with Professor Schneider would develop my understanding of how new diagnostic tests for asthma are evaluated.
The medical school, Technische Universitat Munchen
Endshuldigang (“excuse me / sorry”) fast became my favourite (and most used) word as I travelled through Germany to Munich, the capital of Bavaria. My lack of German language was my main concern prior to departure, but having immersed myself in duolingo (a foreign languages app) I quickly built on my ability to say “sorry”, and survived, mainly due to the extremely friendly and accommodating locals!
On my second day, I visited the Maxmillian Ludwig University Hospital, to spend time at the respiratory function laboratory. Breathing tests can be tough for patients who are required to breathe out as forcefully and quickly as possible (as I learned from personal experience)! The physiologists were brilliantly enthusiastic, shouting “Aus” (Out), “Tief” (Deep) loudly enough to be heard at the end of the corridor!
Completing whole body plethysmography, a form of lung function testing. Breathing inside a closed box with a nose clip wasn’t the nicest experience!
Munich is a beautiful city. It was clean and easy to travel around with impressive architecture and lovely green spaces. As a public health student I was surprised to spot cigarette dispensing machines on the street – not something I’ve come across in Scotland! Spending time researching lung disease concentrates the mind, and I was disappointing to see large numbers of young smokers, seemingly more than in the UK (at least anecdotally). It made me even more impressed at the initiative taken by the Scottish Government to ban smoking.
“Pfeifendes Atemgeräusch und Allergischer Schnupfen”
Analysing data collected in German added a new challenge! The study evaluated 400 adults presenting with symptoms suggestive of asthma. Each individual completed a questionnaire regarding their medical history and symptoms, before undertaking several diagnostic tests. Comparing each ‘test’ to the final diagnosis (asthma or not) made it possible to understand how effective each ‘test’ was in confirming or refuting asthma. ‘Wheeze’ (Pfeifendes Atemgeräusch) and hay fever (Allergischer Schnupfen) were the most useful predictors of asthma.
Studying in Munich was a brilliant experience. Living and travelling in a different city, trying to communicate in a different language, getting used to cultural differences were all really valuable. Yet the best thing was to work with the Munich research group, with whom I built lasting friendships and will continue to work with in the future.