Diagnostic accuracy of bronchodilator responsiveness in wheezy children.
BACKGROUND
The aim of this study was to evaluate the diagnostic accuracy of bronchodilator responsiveness for asthma in 5-10 year old children.


METHODS
Spirometric measurements were made in 142 children (58 wheezers) before and after 400 mug inhaled salbutamol.


RESULTS
On a receiver operating characteristic curve, a 9% increase in predicted forced expiratory volume in 1 second was the cut off point that provided an acceptable balance of sensitivity and specificity for previous wheeze. This figure was 50% (95% CI 38 to 62) sensitive and 86% (95% CI 78 to 92) specific for detecting previous wheeze and multiplied the initial odds in favour of wheeze by a factor of 3.6 (95% CI 2.0 to 6.3).


CONCLUSIONS
With an estimated pretest probability of wheeze of 10% in the community and 50% in a specialist clinic, the positive predictive values are 29% and 78%, respectively, for a 9% change. The value of bronchodilator responsiveness testing depends on the prevalence of wheeze in the population in which it is to be used.
Dundas
I
I
Department of Paediatric Respiratory Medicine, The Royal London Hospital, Barts and The London NHS Trust, London E1 1BB, UK. I.Dundas@qmul.ac.uk
Chan
E Y
EY
Bridge
P D
PD
McKenzie
S A
SA
D000280:Administration, Inhalation; D000420:Albuterol / Q000008:administration & dosage; D001249:Asthma / Q000175:diagnosis*; D001993:Bronchodilator Agents / Q000008:administration & dosage; D002648:Child; D002675:Child, Preschool; D005260:Female; D005541:Forced Expiratory Volume / Q000187:drug effects; D006801:Humans; D008297:Male; D012372:ROC Curve; D012135:Respiratory Sounds / Q000175:diagnosis*; D012680:Sensitivity and Specificity
D001993:Bronchodilator Agents; D000420:Albuterol