title: Effectiveness of screening examinations to detect unrecognized exercise-induced bronchoconstriction.
abstract: 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.
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Medicine, the School of Public Health and Community Medicine, University of Washington, Seattle 98195, USA.
authors.forename: Teal S
authors.initials: TS
authors.lastname: Hallstrand
authors.forename: J Randall
authors.initials: JR
authors.lastname: Curtis
authors.forename: Thomas D
authors.initials: TD
authors.lastname: Koepsell
authors.forename: Diane P
authors.initials: DP
authors.lastname: Martin
authors.forename: Robert B
authors.initials: RB
authors.lastname: Schoene
authors.forename: Sean D
authors.initials: SD
authors.lastname: Sullivan
authors.forename: Gerald N
authors.initials: GN
authors.lastname: Yorioka
authors.forename: Moira L
authors.initials: ML
authors.lastname: Aitken
mesh_terms: 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