TY - JOUR
T1 - Diagnostic properties of inhaled mannitol in the diagnosis of asthma: a population study
AU - Sverrild, Asger
AU - Porsbjerg, Celeste
AU - Thomsen, Simon Francis
AU - Backer, Vibeke
N1 - Keywords: Administration, Inhalation; Adolescent; Asthma; Bronchial Hyperreactivity; Bronchial Provocation Tests; Cross-Sectional Studies; Female; Humans; Male; Mannitol; Questionnaires; Sensitivity and Specificity; Young Adult
Times Cited: 2ArticleEnglishSverrild, ABispebjerg Hosp, Dept Resp Med L, DK-2400 Copenhagen NV, DenmarkCited References Count: 26523XIMOSBY-ELSEVIER360 PARK AVENUE SOUTH, NEW YORK, NY 10010-1710 USANEW YORK
PY - 2009
Y1 - 2009
N2 - BACKGROUND: A new indirect bronchial provocation test measuring airway responsiveness by using inhaled mannitol was recently introduced. OBJECTIVE: The aim of this study was to examine the diagnostic properties of airway responsiveness to inhaled mannitol in the assessment of asthma in an unselected sample of young adults. METHODS: Two hundred thirty-eight young adults randomly drawn from the nationwide civil registration list were challenged with inhaled, dry-powder mannitol. A respiratory specialist, blind to the test results, classified all 238 subjects with respect to the presence of asthma. The classification was based on respiratory symptoms, spirometric results, atopy, and fraction of exhaled nitric oxide values and response to inhaled beta(2)-agonists. On this basis, sensitivity, specificity, and predictive values were assessed to different cutoff values of the test. A receiver operating characteristic curve was constructed, and the accuracy of the test, defined as the area under the curve, was computed. RESULTS: Fifty-one (21.4%) subjects had current asthma. Of 33 subjects with airway hyperresponsiveness to mannitol, 30 had current asthma. The specificity and sensitivity were 98.4% (95% CI, 96.2% to 99.4%) and 58.8% (95% CI, 50.7% to 62.6%), respectively. The positive predictive value (PPV) and negative predictive value (NPV) were 90.9% (95% CI, 78.4% to 96.8%) and 89.8 (95% CI, 87.7% to 90.7%), respectively. The area under the receiver operating characteristic curve was 0.89 (95% CI, 0.83-0.95). CONCLUSIONS: In an unselected sample of young adults, bronchial provocation with inhaled dry-powder mannitol had a high diagnostic specificity for the diagnosis of asthma.
AB - BACKGROUND: A new indirect bronchial provocation test measuring airway responsiveness by using inhaled mannitol was recently introduced. OBJECTIVE: The aim of this study was to examine the diagnostic properties of airway responsiveness to inhaled mannitol in the assessment of asthma in an unselected sample of young adults. METHODS: Two hundred thirty-eight young adults randomly drawn from the nationwide civil registration list were challenged with inhaled, dry-powder mannitol. A respiratory specialist, blind to the test results, classified all 238 subjects with respect to the presence of asthma. The classification was based on respiratory symptoms, spirometric results, atopy, and fraction of exhaled nitric oxide values and response to inhaled beta(2)-agonists. On this basis, sensitivity, specificity, and predictive values were assessed to different cutoff values of the test. A receiver operating characteristic curve was constructed, and the accuracy of the test, defined as the area under the curve, was computed. RESULTS: Fifty-one (21.4%) subjects had current asthma. Of 33 subjects with airway hyperresponsiveness to mannitol, 30 had current asthma. The specificity and sensitivity were 98.4% (95% CI, 96.2% to 99.4%) and 58.8% (95% CI, 50.7% to 62.6%), respectively. The positive predictive value (PPV) and negative predictive value (NPV) were 90.9% (95% CI, 78.4% to 96.8%) and 89.8 (95% CI, 87.7% to 90.7%), respectively. The area under the receiver operating characteristic curve was 0.89 (95% CI, 0.83-0.95). CONCLUSIONS: In an unselected sample of young adults, bronchial provocation with inhaled dry-powder mannitol had a high diagnostic specificity for the diagnosis of asthma.
U2 - 10.1016/j.jaci.2009.06.028
DO - 10.1016/j.jaci.2009.06.028
M3 - Journal article
C2 - 19665779
SN - 0091-6749
VL - 124
SP - 928-32.e1
JO - Journal of Allergy and Clinical Immunology
JF - Journal of Allergy and Clinical Immunology
IS - 5
ER -