Evaluation of recently proposed thresholds to define spirometry bronchodilator response

Area of Science:

• Pulmonary Medicine
• Respiratory Diagnostics

Background:

• The 2022 European Respiratory Society/American Thoracic Society (ERS/ATS) guidelines for spirometry are under review.
• Assessing bronchodilator responsiveness is crucial for diagnosing obstructive lung diseases like asthma.

Discussion:

• The current guidelines might underestimate the prevalence of significant spirometry response to bronchodilators.
• Individuals not identified as responders under these guidelines may still carry a substantial respiratory burden.
• This underestimation could result in increased diagnostic testing and delayed definitive asthma diagnosis.

Key Insights:

• Spirometry response to bronchodilators may be more common than current ERS/ATS guidelines suggest.
• Undiagnosed respiratory burden in patients can lead to prolonged diagnostic delays.
• Current guidelines may require revision to improve early and accurate asthma detection.

Outlook:

• Further research is needed to refine spirometry interpretation criteria for bronchodilator response.
• Revised guidelines could improve patient outcomes by facilitating earlier asthma diagnosis.
• Optimizing diagnostic pathways is essential for managing the global burden of respiratory diseases.