Mannitol challenge testing for asthma in a community cohort of young adults.

Autor: White EC; Telethon Kids Institute, Perth, Perth, Western Australia, Australia.; Centre for Child Health Research, University of Western Australia, Perth, Western Australia, Australia., de Klerk N; Telethon Kids Institute, Perth, Perth, Western Australia, Australia.; Centre for Child Health Research, University of Western Australia, Perth, Western Australia, Australia., Hantos Z; Telethon Kids Institute, Perth, Perth, Western Australia, Australia.; Department of Medical Physics and Informatics, University of Szeged, Szeged, Hungary.; Children's Lung Environment and Asthma Research Team, University of Queensland, Brisbane, Queensland, Australia., Priston M; Telethon Kids Institute, Perth, Perth, Western Australia, Australia., Hollams EM; Telethon Kids Institute, Perth, Perth, Western Australia, Australia.; Centre for Child Health Research, University of Western Australia, Perth, Western Australia, Australia., James A; Department of Pulmonary Physiology/West Australian Sleep Disorders Research Institute, Sir Charles Gardiner Hospital, Perth, Western Australia, Australia.; School of Medicine and Pharmacology, University of Western Australia, Perth, Western Australia, Australia., Sly PD; Children's Lung Environment and Asthma Research Team, University of Queensland, Brisbane, Queensland, Australia., Holt PG; Telethon Kids Institute, Perth, Perth, Western Australia, Australia.; Centre for Child Health Research, University of Western Australia, Perth, Western Australia, Australia.; Children's Lung Environment and Asthma Research Team, University of Queensland, Brisbane, Queensland, Australia., Hall GL; Telethon Kids Institute, Perth, Perth, Western Australia, Australia.; Centre for Child Health Research, University of Western Australia, Perth, Western Australia, Australia.; School of Physiotherapy and Exercise Science, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia.
Jazyk: angličtina
Zdroj: Respirology (Carlton, Vic.) [Respirology] 2017 May; Vol. 22 (4), pp. 678-683. Date of Electronic Publication: 2016 Dec 05.
DOI: 10.1111/resp.12955
Abstrakt: Background and Objective: Mannitol challenge testing is an established tool for clinical asthma diagnosis, and can be performed outside of specialized respiratory laboratories. Despite applicability in both clinical and non-clinical populations, with different pre-test asthma probabilities, differences in diagnostic properties have not been well explored. This study aimed to quantify the diagnostic utility of mannitol challenge testing for asthma in a community cohort and a symptomatic wheezing subset of this cohort.
Methods: During the 22-year follow-up of the Western Australian Pregnancy (Raine) Cohort, 772 participants (384 males) completed mannitol challenge and skin prick testing and respiratory health questionnaires, of whom 148 reporting wheeze in the past 12 months were included in a wheezing subset.
Results: Responsiveness to mannitol had low sensitivity (19%) and high specificity (97%) to identify current asthma in the complete cohort, with positive and negative predictive values (PPV and NPV) of 45% and 92%, respectively. Within the wheezing subset, sensitivity (19%) and specificity (94%) remained similar, but PPV increased to 79%, and NPV decreased to 52%.
Conclusion: Our findings support previously reported high specificity and good PPV for mannitol challenge testing in symptomatic wheezing populations, and highlight the need for caution when interpreting mannitol test results in non-clinical populations.
(© 2016 Asian Pacific Society of Respirology.)
Databáze: MEDLINE
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