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[Application of interrupter resistance pulmonary function testing in the diagnosis of asthma in preschool children: a
Ting-Ting Xu1, Yong Feng1, Yun-Xiao Shang1
1Department of Pediatric Respiratory Medicine, Shengjing Hospital of China Medical University, Shenyang 110004, China.
Insights
Interrupter resistance (Rint) testing aids asthma diagnosis in preschoolers, showing similar value to impulse oscillometry (IOS) but with higher feasibility. A ≥32% change in predicted Rint values can help diagnose asthma in this age group.
Area of Science:
- Pediatric Pulmonology
- Respiratory Physiology
- Diagnostic Testing
Context:
- Asthma diagnosis in preschool children remains challenging due to limited reliable pulmonary function tests.
- Recurrent wheezing is common in preschoolers, necessitating accurate diagnostic tools.
Purpose:
- To evaluate the diagnostic value of interrupter resistance (Rint) pulmonary function testing for asthma in preschool children.
- To compare the efficacy of Rint testing against impulse oscillometry (IOS) in diagnosing childhood asthma.
Summary:
- A prospective study of 108 preschool children (4-<6 years) with recurrent wheezing compared Rint and IOS parameters.
- Asthmatic children showed significantly higher Rint values (P<0.05). Rint testing demonstrated good feasibility, with a 16.7% failure rate for IOS versus none for Rint.
- The percent change in predicted Rint values (≥32%) showed an AUC of 0.705, with 41.0% sensitivity and 91.5% specificity for asthma diagnosis.
Impact:
- Rint pulmonary function testing offers a feasible and valuable tool for assisting in asthma diagnosis in preschool children.
- The findings suggest Rint testing is a viable alternative to IOS, with comparable diagnostic accuracy and better completion rates.
- Establishing a cut-off value (≥32% change in predicted Rint) provides a practical guideline for clinicians.
Objectives:
To investigate the value of interrupter resistance (Rint) pulmonary function testing in the diagnosis of asthma in preschool children, and to compare the significance of Rint pulmonary function testing versus impulse oscillometry (IOS) in the diagnosis of asthma.
Methods:
A prospective study was conducted among 108 children with recurrent wheezing, aged 4 to <6 years, who were admitted from July 2022 to November 2023. According to the treatment outcome, they were divided into an asthmatic group (61 children) and a non-asthmatic group (47 children). Rint pulmonary function parameters and IOS parameters were analyzed for both groups, and the two tests were compared in terms of feasibility and diagnostic value.
Results:
Compared with the non-asthmatic group, the asthmatic group had significantly higher percentage of actual measured value to predicted value for Rint and percent changes in the measured value and predicted value of Rint (P<0.05). The receiver operating characteristic curve analysis showed that the percent change in the predicted value of Rint had an optimal cut-off value of 32.0% in the diagnosis of asthma in preschool children, with an area under the curve (AUC) of 0.705, a sensitivity of 41.0%, and a specificity of 91.5% (P<0.05). In terms of the degree of completion, 18 children (16.7%) failed to complete the IOS test, but they could successfully complete Rint pulmonary function testing with good quality control. Rint pulmonary function testing and IOS had a similar area under the curve in the diagnosis of asthma in preschool children (P>0.05).
Conclusions:
Rint pulmonary function testing can be used to assist in the diagnosis of asthma in preschool children, with a similar diagnostic value to IOS and a relatively high level of feasibility. A percent change of ≥32% in the predicted value of Rint in the bronchial dilation test can be used as a cut-off value for the diagnosis of asthma in preschool children.
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