Sensitivity of different spirometric tests for detecting airway obstruction in childhood asthma

Francisco, Benjamin; Ner, Zarah; Ge, Bin; Hewett, John E.; König, Peter

doi:10.3109/02770903.2014.984842

Cited by 20 publications

(19 citation statements)

References 37 publications

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“…A diffusion defect was defined as a DLCO <80% predicted. A mild diffusion abnormality was defined as 60–79% predicted, moderate as 40–59% predicted, and severe as <40% predicted(21, 22). …”

Section: Methodsmentioning

confidence: 99%

Long-Term Pulmonary Function and Quality of Life in Children After Acute Respiratory Distress Syndrome: A Feasibility Investigation

Ward

Turpin

Spicer

et al. 2017

Pediatric Critical Care Medicine

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Objective Determine the feasibility of pulmonary function (PFT) and quality of life (QOL) evaluations in children after Acute Respiratory Distress Syndrome (ARDS). Design A prospective follow-up feasibility study Setting A tertiary pediatric intensive care unit Patients Children <18 year old with ARDS admitted between 2000 and 2005. Measurements and Main Results PFTs and QOL questionnaires performed approximately 12-months post-illness were analyzed and correlated to in-hospital clinical parameters. QOL data was compared to published pediatric chronic asthma and general pediatric norms. 180 patients met ARDS criteria; 37 (20%) died, 90 (51%) declined participation, 28 (16%) consented but did not return, and 24 (13%) returned for follow up visit. Twenty-three patients completed QOL testing and 17 completed PFTs. Clinical characteristics of those who returned were no different from those who did not except for age (median age 4.9 vs. 1.8 years). One third had mild to moderate pulmonary function deficits. QOL scores were marginal with general health perception, physical functioning, and behavior being areas of concern. These scores were lower than scores in children with chronic asthma. Parental QOL assessments report lower scores in single parent homes but no differences were noted by race or parental employment status. Conclusion Valuable information may be discerned from ARDS patients who return for follow-up evaluation. In this pilot study up to one-third of children with ARDS exhibit pulmonary function deficits and 12-month post-illness QOL scores are lower than in children with chronic asthma. Parental perceptions of post-illness QOL may be negatively impacted by socioeconomic constraints. Long term follow of children with ARDS is feasible and bears further investigation.

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Section: Methodsmentioning

confidence: 99%

Long-Term Pulmonary Function and Quality of Life in Children After Acute Respiratory Distress Syndrome: A Feasibility Investigation

Ward

Turpin

Spicer

et al. 2017

Pediatric Critical Care Medicine

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“…It is confirmed using various tests that measure different aspects of lung function, including expiratory air volume, such as forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV 1 ), or flow, such as peak expiratory flow (PEF) [1,2]. However, such measures have limitations, including relative insensitivity and variability of results, with FVC being more sensitive to small airway obstruction than FEV 1 and PEF, which are more reflective of large airway function [2,3]. Spirometry outcomes in patients with asthma are further influenced by severity of disease and lung function, and also by age, technical ability to perform the test and measurement frequency [4].…”

Section: Introductionmentioning

confidence: 99%

Comparative Responses in Lung Function Measurements with Tiotropium in Adolescents and Adults, and Across Asthma Severities: A Post Hoc Analysis

et al. 2020

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Introduction: Airway obstruction is usually assessed by measuring forced expiratory volume in 1 s (FEV 1 ), forced vital capacity (FVC) and peak expiratory flow (PEF). This post hoc study investigated comparative responses of lung function measurements in adults and adolescents (full analysis set, N = 3873) following treatment with tiotropium Respimat Ò . Methods: Lung function outcomes were analysed from five phase III trials in adults (C 18 years) with symptomatic severe, moderate and mild asthma (PrimoTinA-asthma Ò , Mez-zoTinA-asthma Ò and GraziaTinA-asthma Ò , respectively), and one phase III trial in adolescents (12-17 years) with symptomatic moderate asthma (RubaTinA-asthma Ò ). Changes from baseline versus placebo in FEV 1 , FVC, PEF and FEV 1 /FVC ratio with tiotropium 5 lg or 2.5 lg added to at least stable inhaled corticosteroids at week 24 (week 12 in GraziaTinA-asthma) were analysed. Results: All lung function measures improved in all studies with tiotropium 5 lg (mean change from baseline versus placebo), including peak FEV 1 (110-185 mL), peak FVC (57-95 mL) and morning ). Changes Enhanced Digital features To view enhanced digital features for this article go to https://doi.org/10.6084/ m9.figshare.11941524.

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“…Flows at high lung volumes represent the caliber of the central (large) airways (FEV 1 %), whereas flows at low lung volumes primarily represent the caliber of peripheral (small) airways (FEF 25% , FEF 50% , and FEF 75% ). 8,9 Spirometry has been the most widely used measure of lung function, but no systematic studies of all spirometric tests in terms of sensitivity and specificity have been performed, 10 therefore, identifying a more sensitive and specific indicator to evaluate airway obstruction in children with asthma is necessary.…”

Section: Introductionmentioning

confidence: 99%

Curvilinearity of a Maximum Expiratory Flow-Volume Curve: A Useful Indicator for Assessing Airway Obstruction in Children With Asthma

Xiong

Dai²,

et al. 2019

Respir Care

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BACKGROUND: Lung function parameters are used as signs in the diagnosis and evaluation of asthma; however, their sensitivity and specificity are not ideal. We calculated and combined angle ␤ with lung function parameters to identify the ideal indicator. OBJECTIVE: We aimed to identify an ideal indicator for evaluating the severity of airway obstruction in children with asthma. METHODS: In total, 151 school-age children diagnosed with asthma were selected as the asthma group, and 106 healthy children were selected as the control group. The subjects were divided into the exacerbation group, chronic persistent group, and clinical remission group. Furthermore, the subjects were classified into mild and moderate groups or severe and critical groups. Angle ␤ was calculated in each group. A receiver operating characteristic curve analysis was performed to determine the cutoff values of angle ␤ and lung function parameters that together provided high sensitivity and specificity for airway obstruction evaluation in children with asthma. RESULTS: The mean value of angle ␤ in the asthma group was significantly smaller than that in the control group (178.18°and 196.72°, respectively, P < .001). More exacerbations or greater severity corresponded to smaller angle ␤ values (P < .001). The best cutoff value of angle ␤ was 189.43°, and the area under the receiver operating characteristic curve of angle ␤ was 0.877, which is greater than the area under the receiver operating characteristic curve of FEV 1 , forced expiratory flow (FEF) at 75% vital capacity (FEF 25%), and FEF at 50% vital capacity (FEF 50%), but smaller than the area under the receiver operating characteristic curve of FEF 75% and FEV 1 /FVC%. Interestingly, combining these measures can enhance the sensitivity and specificity in assessing airway obstruction. CONCLUSIONS: Angle ␤ was a useful indicator for assessing airway obstruction. Furthermore, angle ␤ combined with FEV 1 , FEV 1 /FVC%, FEF 25% , FEF 50% , and FEF 75% can enhance the sensitivity and specificity of airway obstruction evaluations.

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Sensitivity of different spirometric tests for detecting airway obstruction in childhood asthma

Abstract: (1) Tests at low lung volumes (small airway tests) are more sensitive than large airway tests; (2) Within groups, the FEV1 is better than PEFR and FEF75 is better than FEF25-75 or FEF50.

Cited by 20 publications

References 37 publications

Long-Term Pulmonary Function and Quality of Life in Children After Acute Respiratory Distress Syndrome: A Feasibility Investigation

Long-Term Pulmonary Function and Quality of Life in Children After Acute Respiratory Distress Syndrome: A Feasibility Investigation

Comparative Responses in Lung Function Measurements with Tiotropium in Adolescents and Adults, and Across Asthma Severities: A Post Hoc Analysis

Curvilinearity of a Maximum Expiratory Flow-Volume Curve: A Useful Indicator for Assessing Airway Obstruction in Children With Asthma

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