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Extended diagnostic criteria used for indirect challenge testing in elite asthmatic swimmers.

Romberg, Kerstin LU ; Tufvesson, Ellen LU and Bjermer, Leif LU (2012) In Respiratory Medicine 106(1). p.15-24
Abstract
The aim of the study was to investigate the prevalence of asthma with or without exercise induced symptoms among elite and elite aspiring swimmers and to compare sport specific exercise provocation with mannitol provocation. METHODS: 101 adolescent swimmers were investigated with mannitol provocation and sport specific exercise challenge test. Mannitol positivity was defined as either direct FEV(1) PD15 (ordinary criteria) or as β(2)-reversibility ≥15% after challenge (extended criteria). A direct positive exercise test was defined as a drop in FEV(1) of 10% (ordinary criteria) or a difference in FEV of ≥15% either spontaneous, variability, or with β2-agonist, reversibility (extended criteria). RESULTS: We found a high prevalence of... (More)
The aim of the study was to investigate the prevalence of asthma with or without exercise induced symptoms among elite and elite aspiring swimmers and to compare sport specific exercise provocation with mannitol provocation. METHODS: 101 adolescent swimmers were investigated with mannitol provocation and sport specific exercise challenge test. Mannitol positivity was defined as either direct FEV(1) PD15 (ordinary criteria) or as β(2)-reversibility ≥15% after challenge (extended criteria). A direct positive exercise test was defined as a drop in FEV(1) of 10% (ordinary criteria) or a difference in FEV of ≥15% either spontaneous, variability, or with β2-agonist, reversibility (extended criteria). RESULTS: We found a high prevalence of mannitol and/or exercise positivity. Twenty-six swimmers were mannitol direct positive and 14 were direct exercise positive using ordinary criteria. Using extended criteria 43 were mannitol positive and 24 were exercise positive. When including reversibility and variability to define a positive test the sensitivity for current asthma with or without exercise induced symptoms increased while the specificity remained roughly unchanged. Direct positivity for mannitol and exercise poorly overlapped using ordinary criteria but improved using extended criteria. CONCLUSION: We found a high prevalence of asthma among elite swimmers. The use of variability and reversibility (liability) as additional criteria to define a positive test provided to our mind relevant information and should be considered. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Respiratory Medicine
volume
106
issue
1
pages
15 - 24
publisher
Elsevier
external identifiers
  • wos:000299449200003
  • pmid:22035852
  • scopus:82955162707
ISSN
1532-3064
DOI
10.1016/j.rmed.2011.09.011
language
English
LU publication?
yes
id
a4cbace8-e30f-4b76-ae0f-7cbbc668acf8 (old id 2221422)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/22035852?dopt=Abstract
date added to LUP
2011-12-01 14:54:03
date last changed
2017-03-26 03:48:23
@article{a4cbace8-e30f-4b76-ae0f-7cbbc668acf8,
  abstract     = {The aim of the study was to investigate the prevalence of asthma with or without exercise induced symptoms among elite and elite aspiring swimmers and to compare sport specific exercise provocation with mannitol provocation. METHODS: 101 adolescent swimmers were investigated with mannitol provocation and sport specific exercise challenge test. Mannitol positivity was defined as either direct FEV(1) PD15 (ordinary criteria) or as β(2)-reversibility ≥15% after challenge (extended criteria). A direct positive exercise test was defined as a drop in FEV(1) of 10% (ordinary criteria) or a difference in FEV of ≥15% either spontaneous, variability, or with β2-agonist, reversibility (extended criteria). RESULTS: We found a high prevalence of mannitol and/or exercise positivity. Twenty-six swimmers were mannitol direct positive and 14 were direct exercise positive using ordinary criteria. Using extended criteria 43 were mannitol positive and 24 were exercise positive. When including reversibility and variability to define a positive test the sensitivity for current asthma with or without exercise induced symptoms increased while the specificity remained roughly unchanged. Direct positivity for mannitol and exercise poorly overlapped using ordinary criteria but improved using extended criteria. CONCLUSION: We found a high prevalence of asthma among elite swimmers. The use of variability and reversibility (liability) as additional criteria to define a positive test provided to our mind relevant information and should be considered.},
  author       = {Romberg, Kerstin and Tufvesson, Ellen and Bjermer, Leif},
  issn         = {1532-3064},
  language     = {eng},
  number       = {1},
  pages        = {15--24},
  publisher    = {Elsevier},
  series       = {Respiratory Medicine},
  title        = {Extended diagnostic criteria used for indirect challenge testing in elite asthmatic swimmers.},
  url          = {http://dx.doi.org/10.1016/j.rmed.2011.09.011},
  volume       = {106},
  year         = {2012},
}