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Related Experiment Videos

Provocation dose and discriminant analysis in histamine bronchoprovocation. Are the current predictive data

V Popa1, J Singleton

  • 1University of California, Davis.

Chest
|September 1, 1988
PubMed
Summary

New research suggests PD20, PD15, and PD20C are the most effective measures for diagnosing asthma. Current diagnostic methods require updated normative data due to significant overlap between normal subjects and asthmatic patients.

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Area of Science:

  • Pulmonary Medicine
  • Diagnostic Immunology
  • Respiratory Physiology

Background:

  • Bronchoprovocation testing is crucial for diagnosing asthma.
  • Current methods for interpreting provocation dose (PD) data have limitations.
  • The use of 'as-needed bronchodilators' complicates diagnostic criteria.

Purpose of the Study:

  • To evaluate the discriminant ability of various provocation dose (PD) metrics in distinguishing between normal subjects and asthmatic patients.
  • To compare different statistical methods for analyzing PD data.
  • To identify the most effective PD measures for asthma diagnosis.

Main Methods:

  • Twenty normal subjects and 20 asthmatic patients were assessed.
  • Several provocation dose metrics (PD40, PD10, PD15, PD20, PD10T, PD20C) were measured.

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  • Discriminant analysis was performed using graphic, ceiling, logistic, and linear methods.

    • Main Results:

    • PD15, PD20, and PD20C demonstrated the lowest mean misclassification error.
    • Logistic and linear methods offered balanced sensitivity and specificity, outperforming the ceiling method.
    • The ceiling method showed high sensitivity but low specificity, indicating limitations.

    Conclusions:

    • PD20, PD15, and PD20C are the most discriminative provocation dose metrics for asthma diagnosis.
    • New normative data for bronchoprovocation testing are necessary.
    • Mathematical models (logistic and linear) provide better discriminant ability than the current ceiling method when data overlap occurs.