Journal article
Asthma tests in the assessment of military conscripts.
- Miedinger D University Hospital, Basel, Switzerland. dmiedinger@uhbs.ch
- Mosimann N
- Meier R
- Karli C
- Florek P
- Frey F
- Scherer K
- Surber C
- Villiger B
- Michel F
- Leuppi JD
- 2009-11-10
Published in:
- Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology. - 2010
Adolescent
Adult
Asthma
Bronchial Provocation Tests
Humans
Male
Mannitol
Methacholine Chloride
Military Personnel
Nitric Oxide
Predictive Value of Tests
Sensitivity and Specificity
Skin Tests
Surveys and Questionnaires
Switzerland
Young Adult
English
BACKGROUND
Respiratory diseases such as asthma may affect individuals' fitness for military service. In order to assess fitness for military service in subjects with asthma symptoms at conscription, objective and reliable tests are needed.
OBJECTIVE
To prospectively determine the diagnostic value of the mannitol and methacholine bronchial provocation test (BPT) as well as exhaled nitric oxide in assessing physician-diagnosed asthma in a group of Swiss Armed Forces conscripts.
METHODS
Questionnaire, spirometry, BPT with methacholine and mannitol, exhaled nitric oxide (FeNO) and skin prick testing were conducted in 18-20-year-old male conscripts. Asthma was diagnosed by a military physician not involved in this study according to the medical record, results of BPT, current respiratory symptoms and use of asthma medication.
RESULTS
Two hundred and eighty four subjects participated in the study. Complete data for the BPT with methacholine, mannitol and measurement of FeNO were available on 235 subjects. Forty-two conscripts (17.9%) had physician-diagnosed asthma. The sensitivity/specificity of mannitol to identify physician-diagnosed asthma was 41%/93% and for methacholine it was 43%/92%. Using a cut-off point of 36.5 p.p.b., FeNO had a similar negative predictive value to rule out physician-diagnosed asthma as BPT with mannitol or methacholine.
CONCLUSION
BPT with mannitol has a sensitivity and specificity similar to methacholine for the diagnosis of physician-diagnosed asthma in military conscripts but is less costly to perform without the need to use and maintain a nebulizer.
Respiratory diseases such as asthma may affect individuals' fitness for military service. In order to assess fitness for military service in subjects with asthma symptoms at conscription, objective and reliable tests are needed.
OBJECTIVE
To prospectively determine the diagnostic value of the mannitol and methacholine bronchial provocation test (BPT) as well as exhaled nitric oxide in assessing physician-diagnosed asthma in a group of Swiss Armed Forces conscripts.
METHODS
Questionnaire, spirometry, BPT with methacholine and mannitol, exhaled nitric oxide (FeNO) and skin prick testing were conducted in 18-20-year-old male conscripts. Asthma was diagnosed by a military physician not involved in this study according to the medical record, results of BPT, current respiratory symptoms and use of asthma medication.
RESULTS
Two hundred and eighty four subjects participated in the study. Complete data for the BPT with methacholine, mannitol and measurement of FeNO were available on 235 subjects. Forty-two conscripts (17.9%) had physician-diagnosed asthma. The sensitivity/specificity of mannitol to identify physician-diagnosed asthma was 41%/93% and for methacholine it was 43%/92%. Using a cut-off point of 36.5 p.p.b., FeNO had a similar negative predictive value to rule out physician-diagnosed asthma as BPT with mannitol or methacholine.
CONCLUSION
BPT with mannitol has a sensitivity and specificity similar to methacholine for the diagnosis of physician-diagnosed asthma in military conscripts but is less costly to perform without the need to use and maintain a nebulizer.
- Language
-
- English
- Open access status
- closed
- Identifiers
-
- DOI 10.1111/j.1365-2222.2009.03387.x
- PMID 19895592
- Persistent URL
- https://sonar.ch/global/documents/205693
Statistics
Document views: 21
File downloads: