TY - JOUR
T1 - Forced expiratory flow between 25% and 75% of vital capacity and FEV 1/forced vital capacity ratio in relation to clinical and physiological parameters in asthmatic children with normal FEV1 values
AU - Simon, Michael R.
AU - Chinchilli, Vernon M.
AU - Phillips, Brenda R.
AU - Sorkness, Christine A.
AU - Lemanske, Robert F.
AU - Szefler, Stanley J.
AU - Taussig, Lynn
AU - Bacharier, Leonard B.
AU - Morgan, Wayne
N1 - Funding Information:
Disclosure of potential conflict of interest: C. A. Sorkness is on advisory boards for GlaxoSmithKline, Schering-Plough, AstraZeneca, and Novartis and receives research support from Schering-Plough and Compleware/Sandoz . R. L. Lemanske is on the speakers' bureau for Merck, AstraZeneca, Doembecher Children's Hospital, Washington University, Medicus Group, Park Nicolet Institute, the American College of Allergy, Asthma & Immunology, the LA Allergy Society, Michigan Allergy/Asthma Society, the Medical College of Wisconsin, the Fund for Medical Research and Education (Detroit), Children's Hospital of Minnesota, the Toronto Allergy Society, AAAAI, Beaumont Hospital (Detroit), the University of Illinois, the Canadian Society of Allergy and Clinical Immunology, and New York Presbyterian; is a consultant for AstraZeneca, Map Pharmaceuticals, Gray Consulting, Smith Research, the Merck Childhood Asthma Network, Novartis, Quintiles/Innovax, RC Horowitz & Co, International Meetings and Science, and Scienomics; is an author for Up-to-Date; and is a textbook editor for Elsevier, Inc. S. J. Szelfer has consultant arrangements with GlaxoSmithKline, Genentech, Merck, Boerhinger Ingelheim, Novartis, and Schering-Plough and receives research support from the National Institutes of Health (NIH)/National Heart, Lung, and Blood Institute (NHLBI), NIH/National Institute of Allergy and Infectious Diseases, GlaxoSmithKline, the National Institute of Environmental Health Sciences, and the Environmental Protection Agency . L. B. Bacharier receives honoraria from AstraZeneca and serves on advisory boards for Genentech, GlaxoSmithKline, Merck, Schering-Plough, and Aerocrine. W. Morgan is a consultant for the Cystic Fibrosis Foundation, Genentech, and Novartis and receives research support from the National Institutes of Health/University of Wisconsin, and Novartis . The rest of the authors have declared that they have no conflict of interest.
PY - 2010/9
Y1 - 2010/9
N2 - Background: The assumption that the assessment of forced expiratory flow between 25% and 75% of vital capacity (FEF25-75) does not provide additional information in asthmatic children with normal FEV1 percent predicted has not been adequately tested. Objective: We sought to determine whether the measurement of FEF25-75 percent predicted offers advantages over FEV1 percent predicted and FEV1/forced vital capacity (FVC) percent predicted for the evaluation of childhood asthma. Methods: This is a secondary analysis of data from the Pediatric Asthma Controller Trial and the Characterizing the Response to a Leukotriene Receptor Antagonist and Inhaled Corticosteroid trials. Pearson correlation coefficients, Pearson partial correlation coefficients, canonical correlations, and receiver operating characteristic (ROC) curves were constructed. Results: Among 437 children with normal FEV1 percent predicted, FEF25-75 percent predicted, and FEV1/FVC percent predicted were (1) positively correlated with log2 methacholine PC20, (2) positively correlated with morning and evening peak expiratory flow percent predicted, and (3) negatively correlated with log10 fraction of exhaled nitric oxide and bronchodilator responsiveness. Pearson partial correlations and canonical correlations indicated that FEF25-75 percent predicted was better correlated with bronchodilator responsiveness and log2 methacholine PC20 than were FEV1 percent predicted or FEV 1/FVC percent predicted. In the ROC curve analysis, FEF 25-75 at 65% of predicted value had a 90% sensitivity and a 67% specificity for detecting a 20% increase in FEV1 after albuterol inhalation. Conclusion: FEF25-75 percent predicted was well correlated with bronchodilator responsiveness in asthmatic children with normal FEV1. FEF25-75 percent predicted should be evaluated in clinical studies of asthma in children and might be of use in predicting the presence of clinically relevant reversible airflow obstruction.
AB - Background: The assumption that the assessment of forced expiratory flow between 25% and 75% of vital capacity (FEF25-75) does not provide additional information in asthmatic children with normal FEV1 percent predicted has not been adequately tested. Objective: We sought to determine whether the measurement of FEF25-75 percent predicted offers advantages over FEV1 percent predicted and FEV1/forced vital capacity (FVC) percent predicted for the evaluation of childhood asthma. Methods: This is a secondary analysis of data from the Pediatric Asthma Controller Trial and the Characterizing the Response to a Leukotriene Receptor Antagonist and Inhaled Corticosteroid trials. Pearson correlation coefficients, Pearson partial correlation coefficients, canonical correlations, and receiver operating characteristic (ROC) curves were constructed. Results: Among 437 children with normal FEV1 percent predicted, FEF25-75 percent predicted, and FEV1/FVC percent predicted were (1) positively correlated with log2 methacholine PC20, (2) positively correlated with morning and evening peak expiratory flow percent predicted, and (3) negatively correlated with log10 fraction of exhaled nitric oxide and bronchodilator responsiveness. Pearson partial correlations and canonical correlations indicated that FEF25-75 percent predicted was better correlated with bronchodilator responsiveness and log2 methacholine PC20 than were FEV1 percent predicted or FEV 1/FVC percent predicted. In the ROC curve analysis, FEF 25-75 at 65% of predicted value had a 90% sensitivity and a 67% specificity for detecting a 20% increase in FEV1 after albuterol inhalation. Conclusion: FEF25-75 percent predicted was well correlated with bronchodilator responsiveness in asthmatic children with normal FEV1. FEF25-75 percent predicted should be evaluated in clinical studies of asthma in children and might be of use in predicting the presence of clinically relevant reversible airflow obstruction.
KW - FEF
KW - FEV /FVC ratio
KW - ROC curves
KW - asthma
KW - bronchodilator responsiveness
KW - canonical correlations
UR - http://www.scopus.com/inward/record.url?scp=77956392962&partnerID=8YFLogxK
U2 - 10.1016/j.jaci.2010.05.016
DO - 10.1016/j.jaci.2010.05.016
M3 - Article
C2 - 20638110
AN - SCOPUS:77956392962
SN - 0091-6749
VL - 126
SP - 527-534.e1-e8
JO - Journal of Allergy and Clinical Immunology
JF - Journal of Allergy and Clinical Immunology
IS - 3
ER -