Measuring breathlessness during histamine challenge: a simple standardized procedure in asthmatic patients

One of the problems in research on symptom perception during histamine challenge has been the difficulty in finding both a valid and practical parameter of the "perceptiveness" for bronchoconstriction in a subject. The purpose of this study was to validate whether the slope in the linear regression model between stimulus and sensation during histamine challenge is an appropriate index for the "perceptiveness" for bronchoconstriction by comparing it with the classical Stevens' law. One hundred and thirty-four asthmatic patients were included in the study and underwent a bronchial challenge with histamine. The relationship between the change in visual analogue scale (VAS) values and the change in forced expiratory volume in one second (FEV1) as percentage of baseline value was analysed by determining both the exponent n in deltaVAS=k x (%deltaFEV1)n and the slope alpha in deltaVAS=k + alpha(%deltaFEV1). The best-fitting line of both the exponential and the linear regression model were determined by the least-squares method in which the percentage explained variation (R2) was compared. The median value of R2 of the exponential regression line and the linear regression line was 0.76 and 0.83, respectively, and significantly different. The Spearman rank correlation coefficient between exponent n in the exponential model deltaVAS=k x (%deltaFEV1)n and the slope alpha in the linear regression model deltaVAS=k + alpha(%deltaFEV1) was 0.87 (95% confidence interval 0.83-0.91). On the basis of the results, it was concluded that the linear regression coefficient can be used as a valid expression to describe the "perceptiveness" of an asthmatic subject instead of Stevens' power function during histamine challenge.