title: Exercise tests in large groups of children are not a suitable screening procedure for undiagnosed asthma.
abstract: Schoolchildren (n = 473), 12-13 years of age, from five schools, and without known asthma, participated in a screening test for exercise-induced asthma (EIA). The children were tested in large groups of 10-15 pupils. Peak expiratory flow (PEF) was measured before, immediately after, and 6-8 min after 6 min of running exercises in a gymnasium. A fall in PEF of at least 10% on two separate test occasions was considered an abnormal result. Children with abnormal results were given an asthma questionnaire and then tested individually in hospital with a standardized exercise test measuring FEV1, PEF, and flow/volume curve. In the screening test, 23 (4.9%) of the 473 children had an abnormal result. When tested in hospital, five (1%) children had a decrease in PEF and/or FEV1 of at least 10% (10-14%) after exercise. Furthermore, three of these five children had a history indicating mild EIA. We conclude that the use of PEF measurement as a screening method for EIA in large groups of schoolchildren cannot be recommended because it yields many false-positive results.
authors.affiliation: Department of Physiotherapy, University Hospital, Uppsala, Sweden.
authors.forename: H
authors.initials: H
authors.lastname: Johansson
authors.forename: T
authors.initials: T
authors.lastname: Foucard
authors.forename: L G
authors.initials: LG
authors.lastname: Pettersson
mesh_terms: D000293:Adolescent; D001249:Asthma / Q000517:prevention & control*; D001250:Asthma, Exercise-Induced / Q000175:diagnosis; D002648:Child; D005080:Exercise Test; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D010366:Peak Expiratory Flow Rate; D011795:Surveys and Questionnaires