A Comparison of the Validity of Different Diagnostic Tests in Adults With Asthma

Hunter, Cameron J.; Brightling, Christopher E.; Woltmann, Gerrit; Wardlaw, Andrew J.; Pavord, Ian D.

doi:10.1378/chest.121.4.1051

Cited by 167 publications

(134 citation statements)

References 26 publications

(37 reference statements)

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“…The assessment of airway inflammation by quantification of induced sputum eosinophils and exhaled nitric oxide measurement offers low sensitivity but high specificity and is predictive of response to corticosteroid therapy [48,49]. The correlation between exhaled nitric oxide fraction (FeNO) and sputum eosinophilia is good in corticosteroid-naive patients, but this relationship is weaker once patients are treated [50].…”

Section: Question 10mentioning

confidence: 99%

Expert opinion on the cough hypersensitivity syndrome in respiratory medicine

et al. 2014

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In 2011, a European Respiratory Society Task Force embarked on a process to determine the position and clinical relevance of the cough hypersensitivity syndrome, a disorder characterised by troublesome coughing often triggered by low levels of thermal, mechanical or chemical exposure, in the management of patients with chronic cough. A 21-component questionnaire was developed by an iterative process supported by a literature review. 44 key opinion leaders in respiratory medicine were selected and interviewed as to their opinions.There was a high degree of unanimity in the responses obtained, with all opinion leaders supporting the concept of cough hypersensitivity as a clinically useful paradigm. The classic stratification of cough into asthmatic, rhinitic and reflux-related phenotypes was supported. Significant disparity of opinion was seen in the response to two questions concerning the therapy of chronic cough. First, the role of acid suppression in reflux cough was questioned. Secondly, the opinion leaders were split as to whether a trial of oral steroids was indicated to establish a diagnosis of eosinophilic cough.The cough hypersensitivity syndrome was clearly endorsed by the opinion leaders as a valid and useful concept. They considered that support of patients with chronic cough was inadequate and the Task Force recommends that further work is urgently required in this neglected area. @ERSpublications Cough hypersensitivity syndrome was clearly endorsed by opinion leaders as a valid and useful concept

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Section: Question 10mentioning

confidence: 99%

Expert opinion on the cough hypersensitivity syndrome in respiratory medicine

et al. 2014

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“…We could not assess whether assessment of peak expiratory flow variability added any value to the tests assessed as these data were not collected. However, abnormal peak flow variability is an insensitive test in patients with symptomatic asthma, 13 suggesting that it would not. Second, there may be differences in symptoms and treatment levels between patients who replied to our study invitation and those who did not; however, the rate of airway abnormality seen in our study is similar to that observed in others.…”

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confidence: 99%

A cross-sectional study of patterns of airway dysfunction, symptoms and morbidity in primary care asthma

Shaw

Green

Berry

et al. 2012

Primary Care Respiratory Journal

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“…From an investigational point of view, all techniques have been widely applied to more or less all disease conditions in order to gain information on the pathogenesis of and, ultimately, improve the ability to diagnose and treat respiratory disorders. From a clinical point of view, each technique has been proposed in selected clinical scenarios [7,[10][11][12][13][14][16][17][18][19]. The clinical application of one of the BAL biomarkers, i.e.…”

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confidence: 99%

“…The clinical application of one of the BAL biomarkers, i.e. cell differential count, is now widely accepted and recommended in clinical guidelines as a diagnostic tool for sarcoidosis and idiopathic pulmonary fibrosis [8,9], while other biomarkers, induced sputum cell counts and FeNO values are considered useful additional tools in the management of asthma [6,7,[10][11][12][13][14][15][16][17][18][19][20]. In contrast, the determination of molecular markers in EBC is still awaiting an accepted clinical application.…”

mentioning

confidence: 99%

Bronchoalveolar lavage, sputum and exhaled clinically relevant inflammatory markers: values in healthy adults

Balbi

Pignatti

Corradi

et al. 2007

European Respiratory Journal

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Bronchoalveolar lavage (BAL), induced sputum and exhaled breath markers (exhaled nitric oxide and exhaled breath condensate) can each provide biological insights into the pathogenesis of respiratory disorders. Some of their biomarkers are also employed in the clinical management of patients with various respiratory diseases. In the clinical context, however, defining normal values and cut-off points is crucial. The aim of the present review is to investigate to what extent the issue of defining normal values in healthy adults has been pursued for the biomarkers with clinical value.The current authors reviewed data from literature that specifically addressed the issue of normal values from healthy adults for the four methodologies.Most studies have been performed for BAL (n59), sputum (n53) and nitric oxide (n53). There are no published studies for breath condensate, none of whose markers yet has clinical value. In healthy adult nonsmokers the cut-off points (mean+2SD) for biomarkers with clinical value were as follows. BAL: 16.7% lymphocytes, 2.3% neutrophils and 1.9% eosinophils; sputum: 7.7610 6 ?mL -1 total cell count and 2.2% eosinophils; nitric oxide: 20.2 ppb. The methodologies differ concerning the quantity and characteristics of available reference data. Studies focusing on obtaining reference values from healthy individuals are still required, more evidently for the new, noninvasive methodologies.

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A Comparison of the Validity of Different Diagnostic Tests in Adults With Asthma

Cited by 167 publications

References 26 publications

Expert opinion on the cough hypersensitivity syndrome in respiratory medicine

Expert opinion on the cough hypersensitivity syndrome in respiratory medicine

A cross-sectional study of patterns of airway dysfunction, symptoms and morbidity in primary care asthma

Bronchoalveolar lavage, sputum and exhaled clinically relevant inflammatory markers: values in healthy adults

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