What is the Best Way to Diagnose Possible Asthma Patients with Negative Bronchodilator Reversibility Tests?
Buket Başa Akdoğan, Ilkay Koca Kalkan, Gözde Köycü Buhari, Özlem Özdedeoğlu, Hale Ateş, Kurtuluş Aksu, Ferda Öner Erkekol Department of Chest Diseases, Division of Immunology and Allergy, University of Health Sciences Ataturk Chest Diseases and...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2024-02-01
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| Series: | Journal of Asthma and Allergy |
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| Online Access: | https://www.dovepress.com/what-is-the-best-way-to-diagnose-possible-asthma-patients-with-negativ-peer-reviewed-fulltext-article-JAA |
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| author | Başa Akdoğan B Koca Kalkan I Köycü Buhari G Özdedeoğlu Ö Ateş H Aksu K Öner Erkekol F |
| author_facet | Başa Akdoğan B Koca Kalkan I Köycü Buhari G Özdedeoğlu Ö Ateş H Aksu K Öner Erkekol F |
| author_sort | Başa Akdoğan B |
| collection | DOAJ |
| description | Buket Başa Akdoğan, Ilkay Koca Kalkan, Gözde Köycü Buhari, Özlem Özdedeoğlu, Hale Ateş, Kurtuluş Aksu, Ferda Öner Erkekol Department of Chest Diseases, Division of Immunology and Allergy, University of Health Sciences Ataturk Chest Diseases and Chest Surgery Education and Research Hospital, Ankara, TurkeyCorrespondence: Buket Başa Akdoğan, Department of Chest Diseases, Division of Immunology and Allergy, University of Health Sciences Ataturk Chest Diseases and Chest Surgery Education and Research Hospital, Incirlist, No: 57 Floor:3, 34147 Bakirkoy/Istanbul, Ankara, Turkey, Tel +90 5053518861 ; +90 850 4339393, Email drbuketakdogan@yahoo.comObjective: The best method and strategy for the diagnosis of asthma remains unclear, especially in patients with negative bronchodilator reversibility test (BDRT). In our study, we aimed to investigate the diagnostic yield of peak expiratory flow (PEF) variability for this patient group.Methods: A total of 50 patients with suspected asthma, all with negative BDR test, were included in the study. Demographic information and symptoms were recorded and PEF variability was monitored for 2 weeks. Metacolinbronchial provocation test (mBPT) was performed. Asthma was diagnosed when PEF variability ≥ 20% and/or positive mBPT was observed.Results: 30 of 50 patients were diagnosed with asthma. After 1 month, 17 patients were evaluated for treatment outcomes. The sensitivity and specificity of PEF variability for different cut-off values (≥ 20%, > 15% and > 10%) were 61.5– 83.3, 88.5– 62.5 and 100– 16.7, respectively. One of the most important findings of our study was the absence of variable airflow limitation or airway hyper reactivity in 39% patients with a previous diagnosis of asthma. Multiple logistic regression analysis revealed that a low baseline FEF25-75 value was an independent predictive factor for the diagnosis of asthma (p= 0.05).Conclusion: The most efficient diagnostic test for asthma is still unclear due to many factors. Our study is one of the few studies on this subject. Although current diagnostic recommendations generally recommend a PEF variability of 10% for the diagnosis of asthma, this threshold may not be appropriate for the BDR-negative patient group. Our results suggest using a threshold value of < 15% for PEF variability when excluding asthma and ≥ 20% when confirming the diagnosis of asthma in patients with clinically suspected but unproven reversibility. Furthermore, FEF25-75 is considered to be an important diagnostic parameter that should be included in diagnostic recommendations for asthma.Keywords: diagnosis of asthma, reversibility, peak expiratory flow (PEF) variability, bronchial challenge test, forced expiratory flow (25-75%) |
| first_indexed | 2024-03-07T22:58:04Z |
| format | Article |
| id | doaj.art-3e26751d6fa34d0f80dee642b8c724e8 |
| institution | Directory Open Access Journal |
| issn | 1178-6965 |
| language | English |
| last_indexed | 2024-03-07T22:58:04Z |
| publishDate | 2024-02-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Journal of Asthma and Allergy |
| spelling | doaj.art-3e26751d6fa34d0f80dee642b8c724e82024-02-22T18:28:25ZengDove Medical PressJournal of Asthma and Allergy1178-69652024-02-01Volume 1711312290640What is the Best Way to Diagnose Possible Asthma Patients with Negative Bronchodilator Reversibility Tests?Başa Akdoğan BKoca Kalkan IKöycü Buhari GÖzdedeoğlu ÖAteş HAksu KÖner Erkekol FBuket Başa Akdoğan, Ilkay Koca Kalkan, Gözde Köycü Buhari, Özlem Özdedeoğlu, Hale Ateş, Kurtuluş Aksu, Ferda Öner Erkekol Department of Chest Diseases, Division of Immunology and Allergy, University of Health Sciences Ataturk Chest Diseases and Chest Surgery Education and Research Hospital, Ankara, TurkeyCorrespondence: Buket Başa Akdoğan, Department of Chest Diseases, Division of Immunology and Allergy, University of Health Sciences Ataturk Chest Diseases and Chest Surgery Education and Research Hospital, Incirlist, No: 57 Floor:3, 34147 Bakirkoy/Istanbul, Ankara, Turkey, Tel +90 5053518861 ; +90 850 4339393, Email drbuketakdogan@yahoo.comObjective: The best method and strategy for the diagnosis of asthma remains unclear, especially in patients with negative bronchodilator reversibility test (BDRT). In our study, we aimed to investigate the diagnostic yield of peak expiratory flow (PEF) variability for this patient group.Methods: A total of 50 patients with suspected asthma, all with negative BDR test, were included in the study. Demographic information and symptoms were recorded and PEF variability was monitored for 2 weeks. Metacolinbronchial provocation test (mBPT) was performed. Asthma was diagnosed when PEF variability ≥ 20% and/or positive mBPT was observed.Results: 30 of 50 patients were diagnosed with asthma. After 1 month, 17 patients were evaluated for treatment outcomes. The sensitivity and specificity of PEF variability for different cut-off values (≥ 20%, > 15% and > 10%) were 61.5– 83.3, 88.5– 62.5 and 100– 16.7, respectively. One of the most important findings of our study was the absence of variable airflow limitation or airway hyper reactivity in 39% patients with a previous diagnosis of asthma. Multiple logistic regression analysis revealed that a low baseline FEF25-75 value was an independent predictive factor for the diagnosis of asthma (p= 0.05).Conclusion: The most efficient diagnostic test for asthma is still unclear due to many factors. Our study is one of the few studies on this subject. Although current diagnostic recommendations generally recommend a PEF variability of 10% for the diagnosis of asthma, this threshold may not be appropriate for the BDR-negative patient group. Our results suggest using a threshold value of < 15% for PEF variability when excluding asthma and ≥ 20% when confirming the diagnosis of asthma in patients with clinically suspected but unproven reversibility. Furthermore, FEF25-75 is considered to be an important diagnostic parameter that should be included in diagnostic recommendations for asthma.Keywords: diagnosis of asthma, reversibility, peak expiratory flow (PEF) variability, bronchial challenge test, forced expiratory flow (25-75%)https://www.dovepress.com/what-is-the-best-way-to-diagnose-possible-asthma-patients-with-negativ-peer-reviewed-fulltext-article-JAAdiagnosis of asthmareversibilitypeak expiratory flow (pef) variabilitybronchial challenge testforced expiratory flow |
| spellingShingle | Başa Akdoğan B Koca Kalkan I Köycü Buhari G Özdedeoğlu Ö Ateş H Aksu K Öner Erkekol F What is the Best Way to Diagnose Possible Asthma Patients with Negative Bronchodilator Reversibility Tests? Journal of Asthma and Allergy diagnosis of asthma reversibility peak expiratory flow (pef) variability bronchial challenge test forced expiratory flow |
| title | What is the Best Way to Diagnose Possible Asthma Patients with Negative Bronchodilator Reversibility Tests? |
| title_full | What is the Best Way to Diagnose Possible Asthma Patients with Negative Bronchodilator Reversibility Tests? |
| title_fullStr | What is the Best Way to Diagnose Possible Asthma Patients with Negative Bronchodilator Reversibility Tests? |
| title_full_unstemmed | What is the Best Way to Diagnose Possible Asthma Patients with Negative Bronchodilator Reversibility Tests? |
| title_short | What is the Best Way to Diagnose Possible Asthma Patients with Negative Bronchodilator Reversibility Tests? |
| title_sort | what is the best way to diagnose possible asthma patients with negative bronchodilator reversibility tests |
| topic | diagnosis of asthma reversibility peak expiratory flow (pef) variability bronchial challenge test forced expiratory flow |
| url | https://www.dovepress.com/what-is-the-best-way-to-diagnose-possible-asthma-patients-with-negativ-peer-reviewed-fulltext-article-JAA |
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