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Journal Information
Vol. 42. Issue 6.
Pages 553-559 (November - December 2014)
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Vol. 42. Issue 6.
Pages 553-559 (November - December 2014)
Original Article
DOI: 10.1016/j.aller.2014.02.004
Utility of bronchodilator response for asthma diagnosis in Latino preschoolers
M. Linares Passerinia,
Corresponding author

Corresponding author.
, R. Meyer Peiranoa, I. Contreras Estaya, I. Delgado Becerrab, J.A. Castro-Rodriguezc
a Pediatric Respiratory Section, Hospital Padre Hurtado, Santiago, Chile
b Faculty of Medicine Clínica Alemana Universidad del Desarrollo, Santiago, Chile
c Departments of Pediatrics and Family Medicine, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
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Figures (1)
Tables (4)
Table 1. Demographic characteristics of healthy controls and asthmatics preschoolers. Data shown as mean (DS or range) for continuous and n (%) for categorical variables.
Table 2. Characteristics of the spirometry variables in controls and asthmatics preschoolers. CV: coefficient of variation.
Table 3. Spirometric values and bronchodilator response (calculated as percentage of change from basal value).
Table 4. Sensitivity, specificity and positive likelihood ratio (+LR) of bronchodilator response (calculate as % of change from basal) using ROC (receiver operating curve).
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Asthma diagnosis in preschoolers is mostly based on clinical evidence, but a bronchodilator response could be used to help confirm the diagnosis. The objective of this study is to evaluate the utility of bronchodilator response for asthma diagnosis in preschoolers by using spirometry standardised for this specific age group.


A standardised spirometry was performed before and after 200mcg of salbutamol in 64 asthmatics and 32 healthy control preschoolers in a case-control design study.


The mean age of the population was 4.1 years (3–5.9 years) and 60% were females. Almost 95% of asthmatics and controls could perform an acceptable spirometry, but more asthmatics than controls reached forced expiratory volume in one second (FEV1) (57% vs. 23%, p=0.033), independent of age. Basal flows and FEV1 were significantly lower in asthmatics than in controls, but no difference was found between groups in forced vital capacity (FVC) and FEV in 0.5s (FEV0.5). Using receiver operating characteristic (ROC) curves, the variable with higher power to discriminate asthmatics from healthy controls was a bronchodilator response (% of change from basal above the coefficient of repeatability) of 25% in forced expiratory flow between 25% and 75% (FEF25–75) with 41% sensitivity, 80% specificity. The higher positive likelihood ratio for asthma equalled three for a bronchodilator response of 11% in FEV0.5 (sensitivity 30%, specificity 90%).


In this sample of Chilean preschoolers, spirometry had a very high performance and bronchodilator response was very specific but had low sensitivity to confirm asthma diagnosis.

Bronchodilator response


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