Effectiveness of screening examinations to detect unrecognized exercise-induced bronchoconstriction.
OBJECTIVE
To determine if a physician-administered physical examination and screening questionnaire accurately detects exercise-induced bronchoconstriction (EIB) in adolescent athletes.


METHODS
Cross-sectional study of 256 adolescents participating in organized sports from 3 suburban high schools. The number of persons screened positive for EIB by physical examination and questionnaire was compared with the number of persons with EIB diagnosed by a "gold standard" test that consisted of a 7-minute exercise challenge followed by serial spirometry.


RESULTS
We diagnosed EIB in 9.4% of adolescent athletes. The screening history identified persons with symptoms or a previous diagnosis suggestive of EIB in 39.5% of the participants, but only 12.9% of these persons actually had EIB. Among adolescents with a negative review of symptoms of asthma or EIB, 7.8% had EIB. Among adolescents with no previous diagnosis of asthma, allergic rhinitis, or EIB, 7.2% had EIB diagnosed by exercise challenge. Persons who screened negative on all questions about symptoms or history of asthma, EIB, and allergic rhinitis accounted for 45.8% of the adolescents with EIB.


CONCLUSIONS
EIB occurs frequently in adolescent athletes, and screening by physical examination and medical history does not accurately detect it.
Hallstrand
Teal S
TS
Division of Pulmonary and Critical Care Medicine, Department of Medicine, the School of Public Health and Community Medicine, University of Washington, Seattle 98195, USA.
Curtis
J Randall
JR
Koepsell
Thomas D
TD
Martin
Diane P
DP
Schoene
Robert B
RB
Sullivan
Sean D
SD
Yorioka
Gerald N
GN
Aitken
Moira L
ML
D000293:Adolescent; D001250:Asthma, Exercise-Induced / Q000453:epidemiology / Q000517:prevention & control*; D003430:Cross-Sectional Studies; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D010808:Physical Examination; D015995:Prevalence; D012372:ROC Curve; D012680:Sensitivity and Specificity; D013147:Spirometry; D013177:Sports; D011795:Surveys and Questionnaires; D014861:Washington / Q000453:epidemiology