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Peak expiratory flow rates in possible occupational asthma
Chest
|July 1, 1991
Summary
Simple criteria for interpreting peak expiratory flow rate (PEFR) readings can help diagnose occupational asthma (OA). Refined criteria improved diagnostic accuracy, showing PEFR is a valuable tool for OA assessment.
Area of Science:
- Occupational Medicine
- Pulmonary Function Testing
Background:
- Occupational asthma (OA) diagnosis relies on objective criteria.
- Peak expiratory flow rate (PEFR) monitoring is a key tool for assessing diurnal variation in airflow.
Purpose of the Study:
- To assess objective criteria for interpreting PEFR readings in suspected occupational asthma.
- To determine the sensitivity and specificity of PEFR interpretation for OA diagnosis.
Main Methods:
- 50 patients with suspected OA underwent at least two weeks of PEFR monitoring.
- PEFR readings were interpreted by two blinded observers using defined criteria for diurnal variation.
- Results were compared against objective diagnoses as the gold standard.
Main Results:
- The prevalence of OA was 36%.
- Initial PEFR interpretation criteria yielded 72% sensitivity and 53% specificity for OA.
- Excluding single-day variations improved sensitivity to 93% and specificity to 77% with acceptable interobserver agreement (kappa 62-83%).
Conclusions:
- Simple, objective criteria for PEFR interpretation can be developed for occupational asthma diagnosis.
- Refined PEFR interpretation criteria demonstrate high sensitivity and specificity.
- PEFR monitoring offers a reliable method for OA assessment with good interobserver reliability.