Physiological tests of small airways function in diagnosing asthma: a systematic review.

Autor:	Almeshari MA; Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK mxa1066@student.bham.ac.uk.; Rehabilitation Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia., Alobaidi NY; Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK.; Respiratory Therapy Department, College of Applied Medical Sciences, King Saud Bin Abdul-Aziz University for Health Sciences, Al Ahsa, Saudi Arabia., Edgar RG; Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK., Stockley J; University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK., Sapey E; Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK.
Jazyk:	angličtina
Zdroj:	BMJ open respiratory research [BMJ Open Respir Res] 2020 Dec; Vol. 7 (1).
DOI:	10.1136/bmjresp-2020-000770
Abstrakt:	Background: Asthma is a common, heterogeneous disease that is characterised by chronic airway inflammation and variable expiratory airflow limitation. Current guidelines use spirometric measures for asthma assessment. This systematic review aimed to assess whether the most commonly reported tests of small airways function could contribute to the diagnosis of asthma. Methods: Standard systematic review methodology was used, and a range of electronic databases was searched (Embase, MEDLINE, CINAHL, CENTRAL, Web of Science, DARE). Studies that included physiological tests of small airways function to diagnose asthma in adults were included, with no restrictions on language or date. The risk of bias and quality assessment tools used were Agency for Healthcare Research and Quality tool for cross-sectional studies and Quality Assessment of Diagnostic Accuracy Studies 2 for diagnostic test accuracy (DTA) studies. Results: 7072 studies were identified and 10 studies met review criteria. 7 included oscillation techniques and 5 included maximal mid-expiratory flow (MMEF). Studies were small and of variable quality. In oscillometry, total resistance (R5) and reactance at 5 Hz (X5) was altered in asthma compared with healthy controls. The percentage predicted of MMEF was lower in patients with asthma compared with controls in all studies and lower than the % predicted forced expiratory volume in 1 s. In DTA of oscillometry, R5 showed a sensitivity between 69% and 72% and specificity between 61% and 86%. Conclusion: There were differences in the results of physiological tests of small airway function in patients with asthma compared with controls. However, studies are small and heterogeneous. Further studies are needed to assess the effectiveness of these tests on a larger scale, including studies to determine which test methodology is the most useful in asthma. Competing Interests: Competing interests: ES reports grants from MRC, grants from Wellcome Trust, grants from NIHR, grants from British Lung Foundation, grants from HDR-UK, outside the submitted work. RGE reports grants from NIHR, grants from Chest Foundation, grants from Alpha 1 Foundation, outside the submitted work. All other authors report no conflict of interest. (© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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