title: Diagnostic accuracy of bronchodilator responsiveness in wheezy children.
abstract: 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.
authors.affiliation: Department of Paediatric Respiratory Medicine, The Royal London Hospital, Barts and The London NHS Trust, London E1 1BB, UK. I.Dundas@qmul.ac.uk
authors.forename: I
authors.initials: I
authors.lastname: Dundas
authors.forename: E Y
authors.initials: EY
authors.lastname: Chan
authors.forename: P D
authors.initials: PD
authors.lastname: Bridge
authors.forename: S A
authors.initials: SA
authors.lastname: McKenzie
mesh_terms: 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
chemical_list: D001993:Bronchodilator Agents; D000420:Albuterol