Spirometric criteria for asthma: Adding further evidence to the debate

Appleton, Sarah; Adams, Robert; Wilson, David H.; Taylor, Anne; Ruffin, Richard E.

doi:10.1016/j.jaci.2005.08.034

Cited by 39 publications

(39 citation statements)

References 41 publications

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“…The prevalence of significant bronchodilator responsiveness (SBR) in the absence of a doctor diagnosis of asthma was 4.6% (n 5 183; males, n 5 86; females, n 5 97) according to the 9% predicted criterion and 2.7% (n 5 109; males, n 5 53; females, n 5 56) according to the 12% of baseline FEV 1 criterion. 30 The significant age-adjusted partial correlations between adiposity measures were generally stronger in male subjects than in female subjects. BMI and WC showed the strongest correlation for both male and female subjects (partial r 5 0.90).…”

Section: Resultsmentioning

confidence: 93%

“…The 9% of predicted criterion was chosen because of its ability to identify impairment in people without a current asthma diagnosis independent of age and sex. 30 Airway obstruction was defined as a postbronchodilator FEV 1 /forced vital capacity ratio less than 2 SDs below that predicted for age and sex. 31 Skin prick testing was conducted for the following allergens: rye grass, cat dander, house dust mite, Alternaria, feather, and cockroach.…”

Section: Sample Population and Study Methodsmentioning

confidence: 99%

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Central obesity is associated with nonatopic but not atopic asthma in a representative population sample

Appleton¹,

Adams²,

Wilson³

et al. 2006

Journal of Allergy and Clinical Immunology

107

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Section: Resultsmentioning

confidence: 93%

Section: Sample Population and Study Methodsmentioning

confidence: 99%

Central obesity is associated with nonatopic but not atopic asthma in a representative population sample

Appleton¹,

Adams²,

Wilson³

et al. 2006

Journal of Allergy and Clinical Immunology

107

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“…This proportion was greater than that observed from a similar study from Australia, in which only 7-18% of participants with current asthma showed bronchodilator reversibility depending on the criteria used. 30 These observations are likely to be due to the widespread use of inhaled corticosteroid treatment, resulting in good asthma control and associated reduction in lung function variability in asthma. The use of bronchodilator reversibility criteria in asthma RCTs may be justified on the basis that it provides the greatest opportunity to determine the maximum efficacy of a therapeutic agent.…”

Section: References Identified Inmentioning

confidence: 99%

External validity of randomised controlled trials in asthma: to whom do the results of the trials apply?

Travers

Marsh

Williams

et al. 2007

Thorax

276

244

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Background: Asthma is a heterogeneous disease with a wide range of clinical phenotypes, not all of which may be encompassed in the subjects included in randomised controlled trials (RCTs). This makes it difficult for clinicians to know to what extent the evidence derived from RCTs applies to a given patient. Aim: To calculate the proportion of individuals with asthma who would have been eligible for the major asthma RCTs from the data of a random community survey of respiratory health. Methods: A postal survey was sent to 3500 randomly selected individuals aged 25-75 years. Respondents were invited to complete a detailed respiratory questionnaire and pulmonary function testing. Participants with current asthma were assessed against the eligibility criteria of the 17 major asthma RCTs cited in the Global Initiative for Asthma (GINA) guidelines. Findings: A total of 749 participants completed the full survey, of whom 179 had current asthma. A median 4% of participants with current asthma (range 0-36%) met the eligibility criteria for the included RCTs. A median 6% (range 0-43%) of participants with current asthma on treatment met the eligibility criteria. Interpretation: This study shows that the major asthma RCTs on which the GINA guidelines are based may have limited external validity as they have been performed on highly selected patient populations. Most of the participants with current asthma on treatment in the community would not have been eligible for these RCTs.

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“…These prevalence estimates may be greater than the estimated prevalence of approximately 7.6% in the general population (48). There was also 4 and 9% bronchodilator reversibility by American Thoracic Society/European Respiratory Society criteria in the two studies, respectively, again reflecting disease prevalence that may be higher than expected in the general population (49). The causes of these apparent increases in asthma and airway disease remain unclear, but recent studies have examined characteristics of asthma in HIV.…”

Section: Obstructive Lung Disease: Associations With Hivmentioning

confidence: 84%

Infections in “Noninfectious” Lung Diseases

et al. 2014

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Many chronic pulmonary diseases, including those that are not primarily infectious in etiology, have some aspects of their pathogenesis that are influenced by infectious organisms. Microorganisms may contribute to chronic lung diseases, either directly (i.e., overt infection) or indirectly, via the amplification of inflammatory pathways that are critical to host defense. As techniques for detecting and characterizing microorganisms have advanced, investigations of both infecting and colonizing organisms have yielded new insights into mechanisms of pulmonary disease. In addition, changes in patterns of infection and microbial resistance have important implications for treatment. Examples of these infectious-pulmonary associations, including Haemophilus influenzae infection and chronic obstructive pulmonary disease, nontuberculous mycobacteria and bronchiectasis, and human immunodeficiency virus and obstructive lung disease, are reviewed.

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Spirometric criteria for asthma: Adding further evidence to the debate

Cited by 39 publications

References 41 publications

Central obesity is associated with nonatopic but not atopic asthma in a representative population sample

Central obesity is associated with nonatopic but not atopic asthma in a representative population sample

External validity of randomised controlled trials in asthma: to whom do the results of the trials apply?

Infections in “Noninfectious” Lung Diseases

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