Literature DB >> 8497822

Measurement of airway responsiveness to methacholine: relative importance of the precision of drug delivery and the method of assessing response.

J R Beach1, C L Young, A J Avery, S C Stenton, J H Dennis, E H Walters, D J Hendrick.   

Abstract

BACKGROUND: The value of measuring airway responsiveness in asthma research is currently limited by the number of different methods used by different investigators, by the lack of a standardised method of expressing precision, and by an inability to equate the results of one method with those of another.
METHODS: Two pairs of measurements of airway responsiveness to methacholine were performed in 20 asthmatic subjects, one pair using a dosimeter method (AR-D) and one pair using the conventional Wright nebuliser tidal breathing method (AR-W). The two methods normally use different techniques for quantifying changing levels in forced expiratory volume in one second (FEV1) after each dose of methacholine (the mean of the highest three of six measurements for AR-D, the lower of two measurements for AR-W), and different techniques for expressing measurements of airway responsiveness (the provoking dose (PD20) and the provoking concentration (PC20) respectively responsible for a 20% decrement in FEV1).
RESULTS: The coefficient of repeatability (and hence precision) for the measurement of airway responsiveness was significantly better for AR-D (3.0) than for AR-W (10.9), but the technique for quantifying FEV1 contributed more to this than the technique for delivering methacholine. A PC20 of 1 mg/ml with AR-W was equivalent to a PD20 of 103 micrograms with AR-D.
CONCLUSIONS: It is practical as well as desirable to compare the precision of different techniques for the measurement of airway responsiveness and to derive conversion factors so that results may be equated.

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Year:  1993        PMID: 8497822      PMCID: PMC464360          DOI: 10.1136/thx.48.3.239

Source DB:  PubMed          Journal:  Thorax        ISSN: 0040-6376            Impact factor:   9.139


  15 in total

1.  Standardization of bronchial inhalation challenge procedures.

Authors:  H Chai; R S Farr; L A Froehlich; D A Mathison; J A McLean; R R Rosenthal; A L Sheffer; S L Spector; R G Townley
Journal:  J Allergy Clin Immunol       Date:  1975-10       Impact factor: 10.793

2.  Bronchial reactivity to inhaled histamine: a method and clinical survey.

Authors:  D W Cockcroft; D N Killian; J J Mellon; F E Hargreave
Journal:  Clin Allergy       Date:  1977-05

3.  Tolerance to methacholine inhalation challenge in nonasthmatic subjects.

Authors:  W S Beckett; W F McDonnell; N D Wong
Journal:  Am Rev Respir Dis       Date:  1988-06

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Authors:  D J Hendrick; L M Fabbri; J M Hughes; D E Banks; H W Barkman; M J Connolly; R N Jones; H Weill
Journal:  Am Rev Respir Dis       Date:  1986-04

5.  An assessment of methacholine inhalation tests in elderly asthmatics.

Authors:  M J Connolly; C Kelly; E H Walters; D J Hendrick
Journal:  Age Ageing       Date:  1988-03       Impact factor: 10.668

6.  Statistical methods for assessing agreement between two methods of clinical measurement.

Authors:  J M Bland; D G Altman
Journal:  Lancet       Date:  1986-02-08       Impact factor: 79.321

7.  Standardization of inhalation provocation tests: two techniques of aerosol generation and inhalation compared.

Authors:  G Ryan; M B Dolovich; R S Roberts; P A Frith; E F Juniper; F E Hargreave; M T Newhouse
Journal:  Am Rev Respir Dis       Date:  1981-02

8.  Reproducibility and comparison of responses to inhaled histamine and methacholine.

Authors:  E F Juniper; P A Frith; C Dunnett; D W Cockcroft; F E Hargreave
Journal:  Thorax       Date:  1978-12       Impact factor: 9.139

9.  Histamine challenge testing: comparison of three methods.

Authors:  J Britton; A Mortagy; A Tattersfield
Journal:  Thorax       Date:  1986-02       Impact factor: 9.139

10.  Influence of the previous deep inspiration on the spirometric measurement of provoked bronchoconstriction in asthma.

Authors:  J Orehek; M M Nicoli; S Delpierre; A Beaupre
Journal:  Am Rev Respir Dis       Date:  1981-03
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  22 in total

1.  Assessment of different methods of inhalation from salbutamol metered dose inhalers by urinary drug excretion and methacholine challenge.

Authors:  Heather S Tomlinson; Sarah A Corlett; Martin B Allen; Henry Chrystyn
Journal:  Br J Clin Pharmacol       Date:  2005-12       Impact factor: 4.335

2.  [Recommendations for implementing bronchial provocation tests with pharmacologic substances. German Society of Pneumology--Scientific "Bronchial Provocation Tests" Study Group].

Authors:  G Klein
Journal:  Med Klin (Munich)       Date:  1997-08-15

3.  Occupational asthma in an isothiazolinone manufacturing plant.

Authors:  S J Bourke; R P Convery; S C Stenton; R M Malcolm; D J Hendrick
Journal:  Thorax       Date:  1997-08       Impact factor: 9.139

4.  Asthma, airways responsiveness and air pollution in two contrasting districts of northern England.

Authors:  G Devereux; T Ayatollahi; R Ward; C Bromly; S J Bourke; S C Stenton; D J Hendrick
Journal:  Thorax       Date:  1996-02       Impact factor: 9.139

5.  The usefulness of competitive PCR: airway gene expression of IL-5, IL-4, IL-4delta2, IL-2, and IFNgamma in asthma.

Authors:  E M Glare; M Divjak; M J Bailey; E H Walters
Journal:  Thorax       Date:  2001-07       Impact factor: 9.139

6.  Changes in methacholine induced bronchoconstriction with the long acting beta 2 agonist salmeterol in mild to moderate asthmatic patients.

Authors:  H Booth; K Fishwick; R Harkawat; G Devereux; D J Hendrick; E H Walters
Journal:  Thorax       Date:  1993-11       Impact factor: 9.139

7.  Effects of fluticasone vs. fluticasone/salmeterol on airway calibre and airway hyperresponsiveness in mild persistent asthma.

Authors:  Graeme P Currie; Suvi Stenback; Brian J Lipworth
Journal:  Br J Clin Pharmacol       Date:  2003-07       Impact factor: 4.335

8.  Comparison of combination inhalers vs inhaled corticosteroids alone in moderate persistent asthma.

Authors:  Daniel K C Lee; Catherine M Jackson; Graeme P Currie; Wendy J Cockburn; Brian J Lipworth
Journal:  Br J Clin Pharmacol       Date:  2003-11       Impact factor: 4.335

9.  The arginine-16 beta2-adrenoceptor polymorphism predisposes to bronchoprotective subsensitivity in patients treated with formoterol and salmeterol.

Authors:  Daniel K C Lee; Graeme P Currie; Ian P Hall; John J Lima; Brian J Lipworth
Journal:  Br J Clin Pharmacol       Date:  2004-01       Impact factor: 4.335

10.  Airway and systemic effects of hydrofluoroalkane fluticasone and beclomethasone in patients with asthma.

Authors:  G P Currie; S J Fowler; A M Wilson; E J Sims; L C Orr; B J Lipworth
Journal:  Thorax       Date:  2002-10       Impact factor: 9.139

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