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Accuracy of spirometry for detection of asthma: a cross-sectional study

机译：肺活量测定法检测哮喘的准确性：一项横断面研究

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ABSTRACT BACKGROUND: Asthma is a chronic inflammatory disease with airway hyperresponsiveness. Spirometry is the most commonly used test among asthmatic patients. Another functional test used for diagnosing asthma is the bronchial challenge test. The aim of this study was to analyze the accuracy of spirometry for detecting asthma in the general population. DESIGN AND SETTING: Cross-sectional study with data analysis to evaluate the accuracy of spirometry through calculating sensitivity, specificity and predictive values and through the kappa agreement test. METHODS: Subjects who constituted a birth cohort were enrolled at the age of 23 to 25 years. Spirometric abnormality was defined as reduced forced expiratory volume in one second, i.e. lower than 80% of the predicted value. Measurement of bronchial responsiveness was performed by means of the bronchial challenge test with methacholine. The gold-standard diagnosis of asthma was defined as the presence of bronchial hyperresponsiveness in association with respiratory symptoms. RESULTS: Asthma was detected in 200 subjects (10.4%) out of the sample of 1922 individuals. Spirometric abnormality was detected in 208 subjects (10.9%) of the sample. The specificity of spirometric abnormality for detecting asthma was 90%, sensitivity was 23%, positive predictive value was 22%, and negative predictive value was 91%. The kappa test revealed weak agreement of 0.13 (95% confidence interval, CI: 0.07-0.19) between spirometry and the diagnosis of asthma. CONCLUSION: Spirometry, as a single test, has limitations for detecting asthma in the general population.
机译：摘要背景：哮喘是一种具有气道高反应性的慢性炎症性疾病。肺活量测定法是哮喘患者中最常用的检查方法。用于诊断哮喘的另一项功能测试是支气管激发试验。这项研究的目的是分析肺活量测定法检测普通人群中哮喘的准确性。设计与设置：进行数据分析的横断面研究，通过计算敏感性，特异性和预测值以及通过kappa一致性测试来评估肺活量测定的准确性。方法：纳入出生队列的受试者年龄为23至25岁。肺功能异常定义为一秒钟内呼气量减少，即低于预测值的80％。支气管反应性的测量是通过用乙酰甲胆碱进行的支气管激发试验来进行的。哮喘的金标准诊断定义为与呼吸道症状相关的支气管高反应性。结果：在1922名个体的样本中，有200名受试者（10.4％）检出了哮喘。在208名样本中（10.9％）检测到肺活量异常。肺功能异常检测哮喘的特异性为90％，敏感性为23％，阳性预测值为22％，阴性预测值为91％。 kappa测试显示肺活量测定法和哮喘诊断之间的一致性较弱，为0.13（95％置信区间，CI：0.07-0.19）。结论：肺活量测定法作为一项单一测试，在检测普通人群中存在局限性。

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