Diagnostic properties of inhaled mannitol in the diagnosis of asthma: a population study

Asger Sverrild; Celeste Porsbjerg; Simon Francis Thomsen; Vibeke Backer

doi:10.1016/j.jaci.2009.06.028

Diagnostic properties of inhaled mannitol in the diagnosis of asthma: a population study

Asger Sverrild, Celeste Porsbjerg, Simon Francis Thomsen, Vibeke Backer

43 Citations (Scopus)

Abstract

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.

Original language	English
Journal	Journal of Allergy and Clinical Immunology
Volume	124
Issue number	5
Pages (from-to)	928-32.e1
Number of pages	5
ISSN	0091-6749
DOIs	https://doi.org/10.1016/j.jaci.2009.06.028
Publication status	Published - 2009

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10.1016/j.jaci.2009.06.028

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@article{65813dd088d311df928f000ea68e967b,

title = "Diagnostic properties of inhaled mannitol in the diagnosis of asthma: a population study",

abstract = "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.",

author = "Asger Sverrild and Celeste Porsbjerg and Thomsen, {Simon Francis} and Vibeke Backer",

note = "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",

year = "2009",

doi = "10.1016/j.jaci.2009.06.028",

language = "English",

volume = "124",

pages = "928--32.e1",

journal = "Journal of Allergy and Clinical Immunology",

issn = "0091-6749",

publisher = "Mosby Inc.",

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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 -

Diagnostic properties of inhaled mannitol in the diagnosis of asthma: a population study

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