{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T13:25:55Z","timestamp":1760189155132},"reference-count":14,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2010,10,20]],"date-time":"2010-10-20T00:00:00Z","timestamp":1287532800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatric Pulmonology"],"published-print":{"date-parts":[[2011,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background:<\/jats:title><jats:p>The operating characteristics of PC<jats:sub>20<\/jats:sub> values used as cut\u2010offs to define airway hyperresponsiveness, as it informs the diagnosis of asthma in children, are poorly understood. We examine data from a unique cohort to inform this concern.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective:<\/jats:title><jats:p>Determine the sensitivity and specificity of incremental PC<jats:sub>20<\/jats:sub> cut\u2010offs for allergist\u2010diagnosed asthma.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods:<\/jats:title><jats:p>Airway reactivity at age 7 was assessed in children within a birth cohort at high risk for asthma; PC<jats:sub>20<\/jats:sub> for methacholine was determined by standard technique including interpolation. The diagnosis of asthma was considered by the pediatric allergist without knowledge of the methacholine challenge results. Sensitivity and specificity were calculated using a cross\u2010tabulation of asthma diagnosis with incremental PC<jats:sub>20<\/jats:sub> cut\u2010off values, from 1.0 to 8.0\u2009mg\/ml, and plotted as receiver operator characteristic (ROC) curves. The \u201coptimal\u201d cut\u2010off was defined as that PC<jats:sub>20<\/jats:sub> conferring maximal value for sensitivity plus specificity while the \u201cbalanced\u201d cut\u2010off was defined as that PC<jats:sub>20<\/jats:sub> at which sensitivity and specificity were most equal.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results:<\/jats:title><jats:p>70\/348 children (20.1%) were diagnosed with asthma. The optimal and balanced PC<jats:sub>20<\/jats:sub> cut\u2010offs, both for all children and for females alone, were respectively 3\u2009mg\/ml (sensitivity 80.0%, specificity 49.1%) and 2\u2009mg\/ml (sensitivity 63.1%, specificity 64.7%). For males alone, the \u201coptimal\u201d and \u201cbalanced\u201d PC<jats:sub>20<\/jats:sub> cut\u2010offs were both 2\u2009mg\/ml.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion:<\/jats:title><jats:p>For this cohort of 7\u2010year olds at high risk for asthma, methacholine challenge testing using a cut\u2010off value of PC<jats:sub>20<\/jats:sub> 3\u2009mg\/ml conferred the maximal sum of specificity plus sensitivity. For contexts in which higher sensitivity or specificity is desired, other cut\u2010offs may be preferred. Pediatr. Pulmonol. 2011; 46:175\u2013178. \u00a9 2011 Wiley\u2010Liss, Inc.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ppul.21347","type":"journal-article","created":{"date-parts":[[2010,10,20]],"date-time":"2010-10-20T19:53:30Z","timestamp":1287604410000},"page":"175-178","source":"Crossref","is-referenced-by-count":12,"title":["Airway hyperresponsiveness to methacholine in 7\u2010year\u2010old children: sensitivity and specificity for pediatric allergist\u2010diagnosed asthma"],"prefix":"10.1002","volume":"46","author":[{"given":"Chris","family":"Carlsten","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Helen","family":"Dimich\u2010Ward","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander","family":"Ferguson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Allan","family":"Becker","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne","family":"DyBuncio","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Moira","family":"Chan\u2010Yeung","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2010,10,20]]},"reference":[{"key":"e_1_2_6_2_2","unstructured":"Global Initiative for Asthma.http:\/\/www.ginasthma.comAccessed June 8 2010."},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.045064"},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1398-9995.1989.tb02265.x"},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1843.1997.tb00061.x"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2005.03.029"},{"key":"e_1_2_6_7_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2222.1977.tb01448.x"},{"key":"e_1_2_6_8_2","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.161.1.ats11-99"},{"key":"e_1_2_6_9_2","doi-asserted-by":"publisher","DOI":"10.1034\/j.1399-3003.1999.14c28.x"},{"key":"e_1_2_6_10_2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200304-556OC"},{"key":"e_1_2_6_11_2","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.20801"},{"key":"e_1_2_6_12_2","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.01.17202460"},{"key":"e_1_2_6_13_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.123.3_suppl.411S"},{"key":"e_1_2_6_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/0140-6736(92)91602-5"},{"key":"e_1_2_6_15_2","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.02.00208102"}],"container-title":["Pediatric Pulmonology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fppul.21347","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ppul.21347","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,21]],"date-time":"2023-11-21T05:18:39Z","timestamp":1700543919000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ppul.21347"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2010,10,20]]},"references-count":14,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2011,2]]}},"alternative-id":["10.1002\/ppul.21347"],"URL":"https:\/\/doi.org\/10.1002\/ppul.21347","archive":["Portico"],"relation":{},"ISSN":["8755-6863","1099-0496"],"issn-type":[{"value":"8755-6863","type":"print"},{"value":"1099-0496","type":"electronic"}],"subject":[],"published":{"date-parts":[[2010,10,20]]}}}