caa a22 4500 467934770 CHVBK 20180406152954.0 cr unu---uuuuu 170328e20060601xx s 000 0 eng 10.1007/s00408-005-2575-y doi (NATIONALLICENCE)springer-10.1007/s00408-005-2575-y Does the Inclusion of Wheeze Detection as an Outcome Measure Affect the Interpretation of Methacholine Challenge Tests? A Study in Workers at Risk of Occupational Asthma [Elektronische Daten] [Abraham Bohadana, J.-P. Michaely] Methacholine $ \dot{\rm V} $ challenge testing (MCT) is widely used to assess airway hyperresponsiveness (AHR). Traditionally, a 20% or greater decline in forced expiratory volume in 1 (FEV1) is the primary outcome measure. We examined whether the inclusion of wheeze detection as outcome measure influenced the categorical interpretation of MCT in workers at risk of occupational asthma (OA). We examined 28 occupationally exposed smokers with asthma-like symptoms (SympAsth), 22 asymptomatic, occupationally exposed smokers (Symp0), and 30 nonexposed, asymptomatic controls (Ctrl). MCT was done using an abbreviated technique. Spirometry and tracheal wheezes were recorded using a computerized system. MCT was considered either positive or negative using three outcome measures separately: (1) ≥ 20% fall in FEV1 (MCT"FEV1”); (2) wheeze appearance (MCT"Wheeze”); and (3) whichever among the two was present (MCT"FEV1Wheeze”). The proportion of reactors in each group were, by outcome measure, as follows: MCT"FEV1”: Ctrl = 2 (6.7%), Symp0 = 6 (27.3%), SympAsth = l2 (42.8%) (χ2 = 10.2; p = 0.006); MCT"Wheeze”: Ctrl = 1 (3.3%), Symp0 = 4 (18.2%), SympAsth = 13 (46.4%) (χ2 = l5.7; p = 0.001); MCT"FEV1Wheeze” Ctrl = 2 (6.7%), Symp0 = 7 (31.8%), SympAsth = 18 (64.3%) (χ2 = 21.5; p = 0.001). Overall, including wheeze detection increased the proportion of "reactors” detected by spirometry by 30% (27 reactors vs. 20). This increase reached 50% (18 vs. 12) among workers with asthma like symptoms. In summary, the inclusion of wheeze detection as outcome measure for MCT allowed the recognition as reactors of subjects that otherwise would be "missed” by spirometry. The resulting increase in the number of true positives improved the sensitivity of MCT to detect AHR in occupationally exposed workers at risk of occupational asthma. Springer Science+Business Media, Inc., 2006 Methacholine challenge testing nationallicence FEV1 nationallicence Wheeze sound nationallicence Occupational asthma nationallicence Bohadana Abraham Institute National de la Santé et de la Recherche Médicale, INSERM ERI 11, 54505, Vandoeuvre-lès-Nancy, France aut Michaely J.-P Institute National de la Santé et de la Recherche Médicale, INSERM ERI 11, 54505, Vandoeuvre-lès-Nancy, France aut Lung Springer-Verlag; www.springer-ny.com 184/3(2006-06-01), 151-157 0341-2040 184:3<151 2006 184 408 https://doi.org/10.1007/s00408-005-2575-y text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00408-005-2575-y text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Bohadana Abraham Institute National de la Santé et de la Recherche Médicale, INSERM ERI 11, 54505, Vandoeuvre-lès-Nancy, France aut NATIONALLICENCE 700 1- Michaely J.-P Institute National de la Santé et de la Recherche Médicale, INSERM ERI 11, 54505, Vandoeuvre-lès-Nancy, France aut NATIONALLICENCE 773 0- Lung Springer-Verlag; www.springer-ny.com 184/3(2006-06-01), 151-157 0341-2040 184:3<151 2006 184 408 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer