The following is a summary of the “Sensitivity of FEV1 and Clinical Parameters in Children With a Suspected Asthma Diagnosis,” published in the January 2023 issue of Allergy and Clinical Immunology by Fillard, et al.
This research aimed to determine how well spirometry and clinical parameters can detect asthma in kids. The VERI-VEMS Study is a worldwide retrospective cohort study conducted at multiple locations. Every child (aged 5-18) who received an asthma diagnosis and had spirometry performed between January 2008 and January 2019 was included in the data set. Using a standard of a physician’s diagnosis of asthma and its response to treatment, they compared the sensitivity of the reversibility criterion proposed by Global Initiative for Asthma (GINA) guidelines to that of other spirometric and clinical variables.
871 kids were included in the research. One study found that a reversibility criterion of 12% of forced expiratory volume in 1 second (FEV1) had a sensitivity of 30.4%. The presence of dry cough, wheezing, or atopy and dry cough, wheezing, or exercise-induced dyspnea had a sensitivity of 99.5%, with no added value of the spirometric parameters in calculating the cumulated sensitivity for the diagnosis of pediatric asthma.
Even though post-bronchodilator reversibility of 12% is crucial for patients’ follow-up, this value is insufficiently low compared to a combination of clinical symptoms that shows a better sensitivity in diagnosing asthma in pediatric patients. The significance of this shift in the diagnostic paradigm for establishing a formal diagnosis of asthma in children will become clearer as more studies are conducted on specificity.
Source: sciencedirect.com/science/article/abs/pii/S2213219822010534
