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Titolo:
Comparisons of peak diurnal expiratory flow variation, postbronchodilator FEV1 responses, and methacholine inhalation challenges in the evaluation ofsuspected asthma
Autore:
Goldstein, MF; Veza, BA; Dunsky, EH; Dvorin, DJ; Belecanech, GA; Haralabatos, IC;
Indirizzi:
MCP Hahnemann Univ, Dept Med & Pediat, Allergy & Immunol Div, Philadelphia, PA USA MCP Hahnemann Univ Philadelphia PA USA Immunol Div, Philadelphia, PA USA MCP Hahnemann Univ, Interdept Med Sci Program, Philadelphia, PA USA MCP Hahnemann Univ Philadelphia PA USA Sci Program, Philadelphia, PA USA
Titolo Testata:
CHEST
fascicolo: 4, volume: 119, anno: 2001,
pagine: 1001 - 1010
SICI:
0012-3692(200104)119:4<1001:COPDEF>2.0.ZU;2-Z
Fonte:
ISI
Lingua:
ENG
Soggetto:
RANDOM-POPULATION SAMPLE; BRONCHIAL RESPONSIVENESS; AIRWAY HYPERRESPONSIVENESS; RESPIRATORY SYMPTOMS; ODENSE SCHOOLCHILD; VARIABILITY; RATES; REACTIVITY; VALIDITY; DISEASE;
Keywords:
diurnal variation; methacholine challenge; peak expiratory flow variation; postbronchodilator FEV1 responses;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
46
Recensione:
Indirizzi per estratti:
Indirizzo: Goldstein, MF Profess Arts Bldg,Suite 300,205 N Broad St, Philadelphia, PA19107 USA Profess Arts Bldg,Suite 300,205 N Broad St Philadelphia PA USA 19107
Citazione:
M.F. Goldstein et al., "Comparisons of peak diurnal expiratory flow variation, postbronchodilator FEV1 responses, and methacholine inhalation challenges in the evaluation ofsuspected asthma", CHEST, 119(4), 2001, pp. 1001-1010

Abstract

Study objectives: The validity of peak expiratory now variation (PEFvar) as defined by National Heart, Lung, and Blood Institute (NHLBI) guidelines as a diagnostic tool for suspected asthma or its comparative value to methacholine inhalation challenge (MTC) or postbronchodilator (ED) FEV1 responseshas not been formally assessed. We prospectively analyzed the correlation of 28 different PEFvar indexes (including 4 NHLBI-compatible indexes) with MIC and pre-ED and post-ED FEV1 responses in suspected asthmatic subjects with normal findings on lung examination, chest radiography, and baseline spirometry,Design: Participants were asked to record peak expiratory now four times daily for 2 to 3 weeks, followed by an MIG. During a minimum 6-month follow-up period, a clinical diagnosis of asthma was made or ruled out based on testing results and response to antiasthma therapy. Setting: Medical school-affiliated subspecialty private practice of allergy, asthma, and immunology,Participants: One hundred twenty-one suspected asthmatic patients with normal findings on lung examination, chest radiography, and baseline spirometry,Measurements and results: Fifty-seven subjects completed both the peak nowdiary and the MIC and were accepted for statistical analysis. There were no statistically significant correlations between any peak expiratory now index and MIG. Among the three diagnostic tools evaluated, MIC had the highest sensitivity (85.71%). All the PEFvar indexes and post-ED responses had low sensitivity and high false-negative rates. Conclusions: PEFvar and post-ED FEV1 responses are poor substitutes for MIC in the assessment of patients with suspected asthma with normal findings on lung examination, chest radiography, and spirometry. Our findings warrant a reconsideration of the NHLBI guidelines recommendation of the utility of PEFvar as a diagnostic tool for asthma in clinical practice.

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Documento generato il 28/02/20 alle ore 23:34:33