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Accurate diagnosis and successful management of asthma for millions of people worldwide was made possible for the first time through the dogged research and determined campaigning of Dr Ian Gregg, who died on 27 April 2009, aged 84, in Oxford.
One of the first clinicians in modern times who spanned the divide between general practice and hospital medicine, sometimes in the face of disapproval from both sides, Gregg devoted most of his working life to improving the treatment of asthma. His pioneering research from the 1960s onwards championed the measurement of peak expiratory flow rate (PEFR) in primary care. "The work he did to establish normal flows and to develop peak flow meters that were useable in the community in everyday settings was hugely important in understanding the disease and allowing higher standards of care," said Mike Thomas, chief medical adviser to Asthma UK.
In a landmark paper in 1964, Gregg laid out a compelling case for GPs routinely to measure PEFR as an indicator of bronchial airway obstruction with the simple and cheap Wright meter, which was then almost solely employed in hospitals (J Coll Gen Pract 1964;7(2):199-214). Gregg encouraged PEFR testing by general practitioners and patients and, with Nunn, went on to establish norms for peak expiratory flow rates, enabling asthma to be objectively assessed and managed for the first time in primary care settings (see BMJ 1973;3:282-4, doi: 10.1136/bmj.3.5874.282 ). Family and friends remember having their PEFR measured as an obligatory part of any visit to...