title: Improving screening and diagnosis of exercise-induced bronchoconstriction: a call to action.
abstract: This article summarizes the findings of an expert panel of nationally recognized allergists and pulmonologists who met to discuss how to improve detection and diagnosis of exercise-induced bronchoconstriction (EIB), a transient airway narrowing that occurs during and most often after exercise in people with and without underlying asthma. EIB is both commonly underdiagnosed and overdiagnosed. EIB underdiagnosis may result in habitual avoidance of sports and physical activity, chronic deconditioning, weight gain, poor asthma control, low self-esteem, and reduced quality of life. Routine use of a reliable and valid self-administered EIB screening questionnaire by professionals best positioned to screen large numbers of people could substantially improve the detection of EIB. The authors conducted a systematic review of the literature that evaluated the accuracy of EIB screening questionnaires that might be adopted for widespread EIB screening in the general population. Results of this review indicated that no existing EIB screening questionnaire had adequate sensitivity and specificity for this purpose. The authors present a call to action to develop a new EIB screening questionnaire, and discuss the rigorous qualitative and quantitative research necessary to develop and validate such an instrument, including key methodological pitfalls that must be avoided.
authors.affiliation: Department of Internal Medicine, University of Iowa, Iowa City, Iowa. Electronic address: jweiler@compleware.com.
authors.forename: John M
authors.initials: JM
authors.lastname: Weiler
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Washington, Seattle, Wash.
authors.forename: Teal S
authors.initials: TS
authors.lastname: Hallstrand
authors.affiliation: Division of Pulmonary, Critical Care, Allergy and Sleep Medicine, The Ohio State University Medical Center, Columbus, Ohio.
authors.forename: Jonathan P
authors.initials: JP
authors.lastname: Parsons
authors.affiliation: Department of Pediatrics, Division of Allergy and Clinical Immunology, Yale University, New Haven, Conn.
authors.forename: Christopher
authors.initials: C
authors.lastname: Randolph
authors.affiliation: Allergy Asthma Colorado, P.C., Englewood, Colo.
authors.forename: William S
authors.initials: WS
authors.lastname: Silvers
authors.affiliation: The William Storms Allergy Clinic, Colorado Springs, Colo.
authors.forename: William W
authors.initials: WW
authors.lastname: Storms
authors.affiliation: BioMedEcon, LLC, Moss Beach, Calif.
authors.forename: Amy
authors.initials: A
authors.lastname: Bronstone
mesh_terms: D001250:Asthma, Exercise-Induced / Q000150:complications / Q000175:diagnosis / Q000209:etiology; D001982:Bronchial Diseases / Q000150:complications / Q000175:diagnosis* / Q000209:etiology*; D016084:Bronchoconstriction / Q000502:physiology*; D015444:Exercise; D006801:Humans; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires / Q000592:standards*
keywords: Asthma; Diagnosis; Exercise-induced bronchoconstriction; Questionnaire: Accuracy; Screening; Validity