0
Clinical Investigations: PULMONARY FUNCTION TESTING |

Sensitivity of Exercise Testing for Asthma in Adolescents Is Halved in the Summer*

Shmuel Goldberg, MD; Shepard Schwartz, MD; Gabriel Izbicki, MD; Ronit Belisha Hamami, BSc; Elie Picard, MD
Author and Funding Information

*From the Departments of Pediatric Pulmonology (Drs. Goldberg and Picard, and Ms. Hamani) and Pediatrics (Dr. Schwartz), Institute of Pulmonology (Dr. Izbicki), Shaare Zedek Medical Center, Jerusalem.

Correspondence to: Shmuel Goldberg, MD, Pediatric Respiratory Medicine, Shaare Zedek Medical Center, PO Box 3235, Jerusalem 91301, Israel; e-mail: pedpul@szmc.org.il



Chest. 2005;128(4):2408-2411. doi:10.1378/chest.128.4.2408
Text Size: A A A
Published online

Study objectives: The exercise test is one of the most widely used challenge tests for asthma. It is not clear if the sensitivity of this test is lower when patients with asthma are not symptomatic. Since asthma activity is season dependent, with lower activity in the summer, we sought to determine if the percentage of positive exercise test results for asthma is lower in the summer as well.

Design: In this retrospective study, the proportion of positive exercise test results for asthma during each of the four seasons of the year, over a 5-year period, was compared.

Setting: The study was conducted at the pediatric respiratory clinic and pulmonary function laboratory of Shaare Zedek Medical Center.

Participants: The study group consisted of 532 consecutive patients, all 17 years of age, who were referred for exercise testing for evaluation of suspected asthma. All had normal baseline FEV1 levels, and none received maintenance asthma treatment.

Measurements and results: Spirometry was performed before and after a standard exercise regimen. A decrease of ≥ 10% in FEV1 after exercise was considered positive; 141 patients (26%) had a positive test result. The percentage of positive results in the summer (July to September quartile) was 12.9%, less than half the percentage of positive results during any of the other three quartiles (January to March, 28.9%, p < 0.05; April to June, 30.6%, p < 0.05; October to December, 29.1%, p < 0.05).

Conclusions: This study shows that the percentage of positive exercise challenge test results in the summer is half that of any other season. It is likely that the lower percentage of positive results for asthma in the summer reflects the lower sensitivity of the test during this season due to decreased asthma activity. We suggest performing exercise challenge testing only when patients are symptomatic. Physicians caring for patients with symptoms suggestive of exercise-induced asthma whose exercise test results are negative while asymptomatic should consider repeat exercise testing when their patients are symptomatic.

Figures in this Article

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Related Content

Customize your page view by dragging & repositioning the boxes below.

CHEST Journal Articles
PubMed Articles
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543