title: A literature review of the evidence that a 12% improvement in FEV1 is an appropriate cut-off for children.
abstract: BACKGROUND
  A well-performed spirometry, using a change in forced expiratory volume in one second (FEV(1)) after albuterol, is commonly used to support the likelihood of an asthma diagnosis. The current standard, accepted by the 2007 National Heart Lung and Blood Institute Asthma Expert Panel Report-3 (EPR-3) guidelines, is a 12% improvement in the FEV(1) after a bronchodilator.
  
  
  OBJECTIVE
  We sought to determine whether existing studies support or refute using a 12% improvement as a significant change in FEV(1) in children and adolescents.
  
  
  METHODS
  We reviewed the literature of children and adolescents using Medline searches to discover pertinent population studies and comparative studies that included FEV(1) measurements.
  
  
  RESULTS
  The majority of the discovered studies suggest a less stringent improvement in FEV(1) in children might be applicable.
  
  
  CONCLUSIONS
  Supported by the published literature, we suggest an alternative interpretive strategy of expressing the results of a spirometry measurement when a diagnosis of asthma in a child is being considered using a bronchodilator response.
authors.affiliation: a Department of Pediatrics , Creighton University , Omaha , NE , USA , and.
authors.forename: Russell J
authors.initials: RJ
authors.lastname: Hopp
authors.affiliation: b Department of Medicine , Albany Medical Center , Albany , NY , USA.
authors.forename: Muhammad A
authors.initials: MA
authors.lastname: Pasha
mesh_terms: D000293:Adolescent; D001249:Asthma / Q000175:diagnosis* / Q000503:physiopathology*; D001993:Bronchodilator Agents; D002648:Child; D005541:Forced Expiratory Volume; D006801:Humans; D013147:Spirometry / Q000706:statistics & numerical data
chemical_list: D001993:Bronchodilator Agents
keywords: Asthma; FEV1; bronchodilator response; bronchodilator tests; children; healthy controls; non-asthmatic