Abstract：
:The diagnostic value of isocapnic hyperventilation of cold air (IHCA) is not fully established. All 342 adult patients in whom IHCA had been performed because of a clinical suspicion of asthma between 1992 and 1994 were analysed retrospectively in the authors' hospital. In addition, 26 healthy subjects were recruited. According to strict criteria, the patients were divided into asthmatics and symptomatic non-asthmatics. For the calculations of sensitivity, specificity and accuracy, the symptomatic non-asthmatic group served as a control. The post-test probability of asthma after IHCA was determined for all the possible pre-test probabilities by applying Bayes' theorem. A linear regression model was used to investigate the factors associated with the reactivity to IHCA. A single 4-min IHCA and skin prick tests were performed in the healthy subjects. Of the 287 patients in the final analysis, 113 were defined as asthmatics and 174 as symptomatic non-asthmatics. The accuracy was highest using a 9.0% fall in forced expiratory volume in 1 s (FEV1) as a cut-off value; the specificity was then 86.8% and the sensitivity 31.9%. The authors found IHCA to be a useful diagnostic test only if the pre-test probability of asthma is between 0.30 and 0.56. The positive final diagnostic gain of IHCA is 22% at its best, but the negative gain is negligible for all possible pre-test probabilities. Factors associated with reactivity to IHCA were young age and, to a lesser extent, a history of cold-weather-associated respiratory symptoms and pre-challenge bronchial obstruction. If a rigid cut-off value for a positive response is used in all age groups, the specificity of IHCA is good but the sensitivity is unacceptably low in adults. The diagnostic value of IHCA might increase if age is taken into account when defining the cut-off value.
journal_name
Respir Medjournal_title
Respiratory medicineauthors
Koskela HO,Räsänen SH,Tukiainen HOdoi
10.1016/s0954-6111(97)90112-8subject
Has Abstractpub_date
1997-09-01 00:00:00pages
470-8issue
8eissn
0954-6111issn
1532-3064pii
S0954-6111(97)90112-8journal_volume
91pub_type
杂志文章abstract：BACKGROUND:Mortality correlates with the Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria of airway obstruction. Yet, little data exist concerning the long-term survival of patients presenting with different levels of obstruction. METHODS:We studied the association between all-cause and cause-spe...
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pub_type： 杂志文章,多中心研究
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pub_type： 临床试验,杂志文章,多中心研究,随机对照试验
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更新日期：1995-08-01 00:00:00
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更新日期：2009-07-01 00:00:00
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pub_type： 杂志文章
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更新日期：2004-02-01 00:00:00
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pub_type： 杂志文章
doi：10.1016/j.rmed.2014.02.011
更新日期：2014-05-01 00:00:00
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更新日期：2001-04-01 00:00:00
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pub_type： 杂志文章
doi：10.1016/j.rmed.2006.02.011
更新日期：2006-11-01 00:00:00
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pub_type： 杂志文章,随机对照试验
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更新日期：2020-01-01 00:00:00
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pub_type： 杂志文章
doi：10.1016/0954-6111(95)90070-5
更新日期：1995-01-01 00:00:00
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pub_type： 杂志文章
doi：10.1016/j.rmed.2011.07.021
更新日期：2012-02-01 00:00:00
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pub_type： 杂志文章
doi：10.1016/j.rmed.2008.07.015
更新日期：2009-01-01 00:00:00
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更新日期：2008-12-01 00:00:00
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pub_type： 杂志文章
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更新日期：2004-09-01 00:00:00
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pub_type： 杂志文章
doi：10.1016/j.rmed.2010.05.004
更新日期：2010-12-01 00:00:00
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doi：10.1053/rmed.2000.0922
更新日期：2000-11-01 00:00:00
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更新日期：2020-01-01 00:00:00
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pub_type： 杂志文章,多中心研究,随机对照试验
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更新日期：2011-09-01 00:00:00
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pub_type： 杂志文章
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更新日期：2003-11-01 00:00:00
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pub_type： 杂志文章
doi：10.1053/rmed.2003.1478
更新日期：2003-05-01 00:00:00
abstract：BACKGROUND:The prevalence of asthma appears to be on the increase, and risk factors are not well established. To investigate risk factors for the development of asthma, a population sample of children and adolescents, aged 7-17 years at enrolment, were studied in 1986. Initial examinations were repeated at follow-up in...
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更新日期：1996-11-01 00:00:00
