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Sensitivity of spirometric and clinical parameters in children with suspected asthma.
Asthma is the most common chronic disease in children. To confirm asthma diagnosis in pediatric patients, GINA recommendations propose a 12% improvement in FEV1 after a bronchodilation test, but such criterion is rarely confirmed in clinical practice.
The VERI-VEMS Study, a multicenter international retrospective cohort study, has recently evaluated the sensitivity of spirometric and clinical parameters in identifying children with possible asthma. The sensitivity of the reversibility criterion proposed by GINA guidelines, has been compared with other spirometric and clinical variables, using physician diagnosed asthma and response to treatment as the standard.
Authors showed that post bronchodilator reversibility of 12%, although essential for patients' follow-up, has an insufficient low sensitivity in reaching a diagnosis of asthma in pediatric patients, compared to a combination of clinical symptoms, that show, on the other hand, a better sensitivity.
Further studies on specificity will help clarify the role of this change in diagnostic paradigm in formally diagnosing children with asthma.
References
Fillard A, Licari A, Molinari N, Marseglia G, Demoly P, Caimmi D. Sensitivity of FEV1 and clinical parameters in children with a suspected asthma diagnosis. J Allergy Clin Immunol Pract. 2022 Oct 21:S2213-2198(22)01053-4. doi: 10.1016/j.jaip.2022.10.011. Epub ahead of print. PMID: 36280139.
