Peak flow variability in the SAPALDIA study and its validity in screening for asthma-related conditions. The SPALDIA Team

Details

Serval ID
serval:BIB_A83446E8C3C1
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Peak flow variability in the SAPALDIA study and its validity in screening for asthma-related conditions. The SPALDIA Team
Journal
American Journal of Respiratory and Critical Care Medicine
Author(s)
Kunzli  N., Stutz  E. Z., Perruchoud  A. P., Brandli  O., Tschopp  J. M., Bolognini  G., Karrer  W., Schindler  C., Ackermann-Liebrich  U., Leuenberger  P.
ISSN
1073-449X (Print)
Publication state
Published
Issued date
08/1999
Volume
160
Number
2
Pages
427-34
Notes
Journal Article
Research Support, Non-U.S. Gov't --- Old month value: Aug
Abstract
We used 3-wk peak expiratory flow (PEF) measurements (twice daily) made in the diary study of the population-based Swiss Study on Air Pollution and Lung Disease in Adults to describe PEF-variability (PEF(var)) (amplitude as a percent of the mean, PEF [i.e., difference between morning and evening values divided by the mean]) in the study population and in five subgroups (physician-diagnosed asthma; current asthma, or physician-diagnosed asthma plus asthma attacks and/or medication; history of wheezing without a cold; hyperreactive; and nonsymptomatic). We assessed the performance of PEF(var) as a potential tool with which to screen for asthma. Alternatively, subjects with a PEF(var) of >/= 20%, >/= 30%, and >/= 50% on at least 2 d were considered to have high variability. The analyses were conducted for subgroups with different pretest probabilities for asthma-related conditions. The median PEF(var) was 4.5%. Among asthmatic subjects, women had nonsignificantly higher PEF(var) values than did men. In all other groups, women had significantly lower PEF(var). Both in the entire population and in subgroups with a higher pretest probability for asthma-related conditions, screening performance of PEF was limited. A PEF(var) of >/= 20% on at least 2 d detected current asthma with a sensitivity of 36% (specificity = 90%; positive predictive value = 16.4%). Results were better among subjects with a history of wheezing without colds (sensitivity = 40.4%; specificity = 83.6%; positive predictive value = 45.2%). PEF(var), a useful measure both clinically and in epidemiology, is of limited value when unselected populations are screened for asthma-related conditions, since the overlap of PEF(var) distributions across subgroups is large.
Keywords
Adolescent Adult Air Pollution/*adverse effects Asthma/*diagnosis/epidemiology Circadian Rhythm Cross-Sectional Studies Female Humans Male *Mass Screening Middle Aged *Peak Expiratory Flow Rate/drug effects *Population Surveillance Predictive Value of Tests Risk Factors Switzerland/epidemiology
Pubmed
Web of science
Create date
25/01/2008 10:50
Last modification date
20/08/2019 16:12
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