Predictive value of respiratory symptoms and bronchial hyperresponsiveness to diagnose asthma in New Zealand

Respiratory symptoms are often used as the only diagnostic criteria for asthma in epidemiological surveys and the clinical diagnosis of asthma relies primarily on a detailed history. The aim of this study is to predict the diagnostic value of 11 different respiratory symptoms to diagnose asthma, and...

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Veröffentlicht in:Respiratory medicine 2006-12, Vol.100 (12), p.2107-2111
Hauptverfasser: Sistek, D., Wickens, K., Amstrong, R., D’Souza, W., Town, I., Crane, J.
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container_end_page 2111
container_issue 12
container_start_page 2107
container_title Respiratory medicine
container_volume 100
creator Sistek, D.
Wickens, K.
Amstrong, R.
D’Souza, W.
Town, I.
Crane, J.
description Respiratory symptoms are often used as the only diagnostic criteria for asthma in epidemiological surveys and the clinical diagnosis of asthma relies primarily on a detailed history. The aim of this study is to predict the diagnostic value of 11 different respiratory symptoms to diagnose asthma, and to determine if bronchial hyperresponsiveness (BHR) improves the predictive value of these respiratory symptoms. A random sample of 1257 subjects aged 20–44 years old in 3 different areas of New Zealand were selected between March 1991 and December 1992 to answer the European Community Respiratory Health Survey questionnaire on respiratory symptoms. Of these, 784 underwent bronchial challenge with methacholine. The prevalence of current doctor diagnosed asthma (DDA) defined as asthma confirmed by a physician and an asthma attack in the last 12 months was 8.3%. Wheezing with dyspnoea is the single best predictor of diagnosed asthma with a sensitivity of 82%, a specificity of 90% and a Youden's index of 0.72. Wheezing alone is more sensitive (94%) but less specific (76%), with a Youden's index of 0.70. The addition of BHR to asthma symptoms decreases sensitivity and increases specificity with a small increase in Youden's index to 0.75. In New Zealand adults, a history of wheezing with BHR best predicts a diagnosis of asthma but wheezing alone or with dyspnoea are the two best symptoms for predicting asthma.
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The aim of this study is to predict the diagnostic value of 11 different respiratory symptoms to diagnose asthma, and to determine if bronchial hyperresponsiveness (BHR) improves the predictive value of these respiratory symptoms. A random sample of 1257 subjects aged 20–44 years old in 3 different areas of New Zealand were selected between March 1991 and December 1992 to answer the European Community Respiratory Health Survey questionnaire on respiratory symptoms. Of these, 784 underwent bronchial challenge with methacholine. The prevalence of current doctor diagnosed asthma (DDA) defined as asthma confirmed by a physician and an asthma attack in the last 12 months was 8.3%. Wheezing with dyspnoea is the single best predictor of diagnosed asthma with a sensitivity of 82%, a specificity of 90% and a Youden's index of 0.72. Wheezing alone is more sensitive (94%) but less specific (76%), with a Youden's index of 0.70. The addition of BHR to asthma symptoms decreases sensitivity and increases specificity with a small increase in Youden's index to 0.75. 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subjects Adult
Airway management
Asthma
Asthma - diagnosis
Asthma - epidemiology
Asthma - physiopathology
Biological and medical sciences
Bronchial Hyperreactivity - etiology
Bronchial Hyperreactivity - physiopathology
Bronchial hyperresponsiveness
Bronchial Provocation Tests - methods
Chronic obstructive pulmonary disease, asthma
Dyspnea - etiology
Family physicians
Female
Gender differences
Humans
Male
Medical sciences
New Zealand - epidemiology
Pneumology
Predictive value
Predictive Value of Tests
Prevalence
Questionnaires
Respiratory diseases
Respiratory Sounds - etiology
Respiratory symptoms
Sensitivity and Specificity
Sex Distribution
title Predictive value of respiratory symptoms and bronchial hyperresponsiveness to diagnose asthma in New Zealand
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