Processes of provided care may affect the observed association between excess weight and outcomes for critically ill adults and should be considered when making inferences about observed results. It is unknown if disparities in processes of care are due to clinically justified reasons for variation, bias against heavier patients, or other reasons.

Vocal cord dysfunction occurs across the spectrum of asthma severity. There was a lack of previously described "classic" VCD symptoms among asthmatics. Symptoms were diverse and not easily distinguished from common symptoms of asthma, highlighting the need for a high index of suspicion for VCD in patients with asthma. Failure to consider and diagnose VCD may result in misleading assumptions about asthma control, and result in unnecessary adjustments of asthma medications. The high prevalence of GERD raises the question of the role of acid reflux in the pathogenesis of VCD in asthmatics.

We present the first description of the clinical use of EVH testing for the diagnosis of EIB in a large pulmonary practice. EVH was diagnostic in a large majority of patients. EVH is an excellent and feasible modality to diagnose EIB in patients seen in a general pulmonary practice. Our data highlight the need for further studies regarding the appropriate minimum threshold minute ventilation for an EVH test and to explain potential mechanisms for seemingly different stimulus thresholds for bronchospasm in males versus females.