| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
Guest Access | Sign In via User Name/Password
|
|
|
|||||||
Guest Access | Sign In via User Name/Password |
|||||||||
Chest, Vol 102, 347-355, Copyright © 1992 by American College of Chest Physicians
ARTICLES |
AH Eliasson, YY Phillips, KR Rajagopal and RS Howard
Department of Medicine, Walter Reed Army Medical Center, Washington, DC 20307-5001.
The thresholds used to define a positive result for bronchial provocation challenges (BPC) are arbitrary. Requiring smaller decrements in expired flow to define a positive study would capture more cases of reactive airways (increased sensitivity) but would include some "normal" responses (decreased specificity). To examine the relationship between threshold definition and the ability to correctly classify subjects as either normal or as having airways hyperresponsiveness (AHR), four different BPC tests were administered on different days to 20 patients with a clinical diagnosis of exercise- induced bronchospasm (EIB) and 20 control subjects. The four BPC tests were indoor exercise on a cycle ergometer, methacholine inhalation challenge (MIC), eucapnic voluntary hyperventilation (EVH) with dry gas, and EVH with cold gas. Our results indicate that the thresholds which best separate the two groups are different for each of the four BPC techniques. For methacholine inhalation (MIC), a fall in FEV1 (d%FEV1) of 15 percent or greater at 188 cumulative breath units was 100 percent specific for AHR but had a sensitivity of only 55 percent. Eucapnic voluntary hyperventilation (EVH) with room temperature dry gas was 100 percent specific at a d%FEV1 of 11 percent, but, at that threshold, sensitivity was only 50 percent. EVH with cold air was 100 percent specific at a d%FEV1 of 12 percent but sensitivity was only 35 percent. The bicycle ergometer challenge was far too insensitive to be of value in evaluating AHR. Based on their respective receiver operating characteristic curves, the best separation of the two subject groups occurred at a d%FEV1 of 5 percent and 12 percent for the two EVH techniques and MIC, respectively. An individual's response to one test was highly correlated with the response to either of the other two (r = 0.66, p less than 0.001 for dry vs cold gas EVH; r = 0.56, p less than 0.001 for dry gas EVH vs methacholine; and r = 0.69, p less than 0.001 for cold gas EVH vs methacholine). Thus, MIC and EVH techniques are equally useful in defining AHR and each has its optimal threshold for a positive test result.
This article has been cited by other articles:
|
|
 |
|
  D. Miedinger, P. N. Chhajed, M. Tamm, D. Stolz, C. Surber, and J. D. Leuppi Diagnostic Tests for Asthma in Firefighters Chest, June 1, 2007; 131(6): 1760 - 1767. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K Holzer and J A Douglass Exercise induced bronchoconstriction in elite athletes: measuring the fall Thorax, February 1, 2006; 61(2): 94 - 96. [Full Text] [PDF]
|
|
|
|
|
|
J. P. Parsons and J. G. Mastronarde Exercise-Induced Bronchoconstriction in Athletes Chest, December 1, 2005; 128(6): 3966 - 3974. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M Seear, D Wensley, and N West How accurate is the diagnosis of exercise induced asthma among Vancouver schoolchildren? Arch. Dis. Child., September 1, 2005; 90(9): 898 - 902. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. G. Nielsen and H. Bisgaard Hyperventilation with Cold versus Dry Air in 2- to 5-Year-Old Children with Asthma Am. J. Respir. Crit. Care Med., February 1, 2005; 171(3): 238 - 241. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G.F. Joos and B. O'Connor Indirect airway challenges Eur. Respir. J., June 1, 2003; 21(6): 1050 - 1068. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Holzer, S. D. Anderson, H.-K. Chan, and J. Douglass Mannitol as a Challenge Test to Identify Exercise-induced Bronchoconstriction in Elite Athletes Am. J. Respir. Crit. Care Med., February 15, 2003; 167(4): 534 - 537. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. J. Perkins and M. J. Morris Vocal Cord Dysfunction Induced by Methacholine Challenge Testing Chest, December 1, 2002; 122(6): 1988 - 1993. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B.-M. Sundblad, L. Palmberg, and K. Larsson Bronchial Responsiveness to Eucapnic Hyperventilation and Methacholine Following Exposure to Organic Dust* Chest, July 1, 2002; 122(1): 363 - 368. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. Moloney, S. O'Sullivan, T. Hogan, L. W. Poulter, and C. M. Burke Airway Dehydration* : A Therapeutic Target in Asthma? Chest, June 1, 2002; 121(6): 1806 - 1811. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S T Remes, J Pekkanen, K Remes, R O Salonen, and M Korppi In search of childhood asthma: questionnaire, tests of bronchial hyperresponsiveness, and clinical evaluation Thorax, February 1, 2002; 57(2): 120 - 126. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Y. Y. Phillips and R. D. Schreiner Streamlining Methacholine Challenge Testing Chest, December 1, 2001; 120(6): 1763 - 1765. [Full Text] [PDF]
|
|
|
|
 |
|
 S D Anderson, G J Argyros, H Magnussen, and K Holzer Provocation by eucapnic voluntary hyperpnoea to identify exercise induced bronchoconstriction Br. J. Sports Med., October 1, 2001; 35(5): 344 - 347. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. A. KAMINSKY and M. LYNN Pulmonary Capillary Blood Volume in Hyperpnea-induced Bronchospasm Am. J. Respir. Crit. Care Med., November 1, 2000; 162(5): 1668 - 1673. [Abstract] [Full Text]
|
|
|
|
|
|
K. G. NIELSEN and H. BISGAARD Lung Function Response to Cold Air Challenge in Asthmatic and Healthy Children of 2-5 Years of Age Am. J. Respir. Crit. Care Med., June 1, 2000; 161(6): 1805 - 1809. [Abstract] [Full Text]
|
|
|
|
|
|
R. Crapo Guidelines for Methacholine and Exercise Challenge Testing---1999 . THIS OFFICIAL STATEMENT OF THE AMERICAN THORACIC SOCIETY WAS ADOPTED BY THE ATS BOARD OF DIRECTORS, JULY 1999 Am. J. Respir. Crit. Care Med., January 1, 2000; 161(1): 309 - 329. [Full Text]
|
|
|
|
|
|
M. J. Morris, L. E. Deal, D. R. Bean, V. X. Grbach, and J. A. Morgan Vocal Cord Dysfunction in Patients With Exertional Dyspnea* Chest, December 1, 1999; 116(6): 1676 - 1682. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. H. Eliasson Blow Dry Your Asthma Chest, March 1, 1999; 115(3): 608 - 609. [Full Text] [PDF]
|
|
|
|
|
|
E. T. Mannix, F. Manfredi, and M. O. Farber A Comparison of Two Challenge Tests for Identifying Exercise-Induced Bronchospasm in Figure Skaters Chest, March 1, 1999; 115(3): 649 - 653. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. D. BRANNAN, H. KOSKELA, S. D. ANDERSON, and N. CHEW Responsiveness to Mannitol in Asthmatic Subjects with Exercise- and Hyperventilation-induced Asthma Am. J. Respir. Crit. Care Med., October 1, 1998; 158(4): 1120 - 1126. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. D. ANDERSON, J. BRANNAN, J. SPRING, N. SPALDING, L. T. RODWELL, K. CHAN, I. GONDA, A. WALSH, and A. R. CLARK A New Method For Bronchial-provocation Testing in Asthmatic Subjects Using a Dry Powder of Mannitol Am. J. Respir. Crit. Care Med., September 1, 1997; 156(3): 758 - 765. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
