Bronchial reactivity in the community

Tattersfield, AE; Higgins, B. E.

doi:10.1183/09031936.93.01050476

Cited by 8 publications

(1 citation statement)

References 5 publications

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“…Bronchial responsiveness and asthma were found to be closely associated, although it is well known that BHR and asthma are not identical [5,12,21,32]. Differentiation between BHR and normal bronchial responsiveness is arbitrary [9,33,34], and follow-up studies of population samples in the future might reveal whether increased degree of bronchial responsiveness increases the future risk of developing respiratory symptoms with time.…”

Section: Discussionmentioning

confidence: 99%

Sensitivity and specificity of the histamine challenge test for the diagnosis of asthma in an unselected sample of children and adolescents

Backer¹,

Groth²,

Dirksen³

et al. 1991

Eur Respir J

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The purpose of this investigation was to study factors of importance for the degree of bronchial responsiveness and, furthermore, to evaluate the sensitivity, specificity and predictive value of a bronchial challenge test with histamine for the diagnosis of asthma in 495 randomly selected children and adolescents, aged 7-16 yrs, from Copenhagen, Rigshospitalet. Detailed history about allergic symptoms, physical examination and bronchial histamine challenge tests were performed at the out-patient clinic. Asthma, atopic disease and height were found to be of great importance for the degree of bronchial responsiveness, whereas the age, sex and smoking habits were of no significance. The percentage of asthmatics with bronchial hyperresponsiveness, i.e. sensitivity to the test, increased towards 100% on inhaling increasing concentrations of histamine, but this was accompanied by a decrease in specificity and predictive values of positive test in regard to the diagnosis of asthma. However, lower concentrations of histamine may be preferable in order to distinguish between asthma and non-asthma in population samples, as inhalation of 2.4 mg.ml-1 and provocative concentration producing a 20% fall in forced expiratory volume in one second (FEV1) (PC20) provided an acceptable sensitivity (57%), specificity (98%), and predictive value of a positive test (60%). We conclude that as regards the diagnosis of asthma, a low predictive value confirms that the bronchial challenge test plays only a supplementary, but valuable, role in detecting the disease in population samples.

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