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Abstract: Poster Presentations |

A CLINCAL DIAGNOSIS OF ASTHMA DOES NOT CORRELATE WELL WITH ATS FEV1 BRONCHODILATOR CRITERA FREE TO VIEW

John A. Gjevre, MD*; Thomas S. Hurst, DVM; Regina M. Taylor-Gjevre, MD; Donald W. Cockcroft, MD
Author and Funding Information

University of Saskatchewan, Saskatoon, SK, Canada


Chest


Chest. 2005;128(4_MeetingAbstracts):242S. doi:10.1378/chest.128.4_MeetingAbstracts.242S
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Abstract

PURPOSE:  The ATS has developed criteria suggesting that a significant post-bronchodilator FEV1 response is 200 ml and 12% improvement. To our knowledge, the ATS criteria never been validated versus the clinical diagnosis of asthma.

METHODS:  All spirometry tests done from Sept 1999 to Sept 2004 were analyzed for meeting the ATS criteria for FEV1 improvement There were a total of 1862 tests meeting the ATS FEV1 criteria with a total of 644 individual non-duplicate records. A total of 311 individual patient records were analyzed for staff respirologists.

RESULTS:  311 patients were found who met ATS FEV1 criteria and whose complete physician records were available. There were 170 men and 141 women with a median age of 62.8 years. Of the 311 patients meeting a 12% FEV1 change, there were 170 (54.7%) diagnosed by the staff respirologist with asthma. Of the 208 patients meeting a 15% FEV1 improvement, there were 120 (57.7%) diagnosed with asthma. Of the 98 patients meeting a 20% FEV1 improvement, there were 62 (63.3%) patients diagnosed by the staff respirologist with asthma. For the diagnosis of asthma versus not asthma, there was a statistically significant difference in the post-bronchodilator FEV1 % improvement with p=0.02 (CI 0.256-3.02). Of the 170 patients with asthma (for 12% FEV1 response), there was a mean improvement in FEV1 of 19.4% (SD 6.87), while the 140 not asthma patients had a mean improvement in FEV1 of 17.8% (SD 5.53).

CONCLUSION:  While the ATS FEV1 criteria are a help in asthma diagnosis, relying on spirometric criteria alone is inadequate in asthma diagnosis. Only 170 patients (54.7%) meeting ATS bronchodilator improvement criteria were felt to clinically have asthma.

CLINICAL IMPLICATIONS:  The diagnosis of asthma requires a clinical history and physical examination. Spirometry changes are helpful but the level of bronchodilator significance remains unclear.

DISCLOSURE:  John Gjevre, None.

Wednesday, November 2, 2005

12:30 PM - 2:00 PM


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