{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T09:59:30Z","timestamp":1790589570711,"version":"4.1.0"},"reference-count":38,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T00:00:00Z","timestamp":1790553600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T00:00:00Z","timestamp":1790553600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Paediatrica"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>We compared how well impulse oscillometry (IOS) and spirometry detected small airway dysfunction (SAD) in children with asthma and evaluated associations between IOS abnormalities, asthma control, and asthma severity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This observational study comprised 106 children aged 6\u201318\u2009years with asthma who underwent IOS and spirometry before and after bronchodilator administration. We assessed SAD, bronchodilator responsiveness, asthma control using the Global Initiative for Asthma criteria and asthma severity using the Composite Asthma Severity Index.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Most children had mild asthma and preserved spirometry. Spirometry and IOS identified abnormalities suggestive of SAD in 10.4% and 37.7% of patients, respectively, and bronchodilator responsiveness in 12.3% and 20.8%, respectively. IOS abnormalities were not associated with asthma control, while only weak associations were observed between selected IOS parameters and asthma severity. Correlations between oscillometric and spirometric indices were significant but weak.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>IOS detected physiological abnormalities more frequently than spirometry in children with largely preserved lung function. However, these additional abnormalities were not associated with current asthma control and only showed weak associations with asthma severity. IOS should be considered a complementary physiological assessment. Longitudinal studies are needed to establish the clinical relevance and prognostic significance of these findings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/apa.70763","type":"journal-article","created":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T09:42:13Z","timestamp":1790588533000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Impulse Oscillometry Detected Physiological Abnormalities More Frequently Than Spirometry in Children With Largely Preserved Lung Function"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7336-4292","authenticated-orcid":false,"given":"Paola","family":"Di Filippo","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Pediatric Allergy and Pulmonology Unit University of Chieti\u2010Pescara  Chieti Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3278-1561","authenticated-orcid":false,"given":"Annamaria","family":"Porreca","sequence":"additional","affiliation":[{"name":"Department of Human Sciences and Quality of Life Promotion San Raffaele University  Rome Italy"},{"name":"Clinical and Molecular Epidemiology IRCCS San Raffaele Rome  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Duilio","family":"Petrongari","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Pediatric Allergy and Pulmonology Unit University of Chieti\u2010Pescara  Chieti Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimiliano","family":"Raso","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Pediatric Allergy and Pulmonology Unit University of Chieti\u2010Pescara  Chieti Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benedetta","family":"Ciccone","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Pediatric Allergy and Pulmonology Unit University of Chieti\u2010Pescara  Chieti Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabrina","family":"Di Pillo","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Pediatric Allergy and Pulmonology Unit University of Chieti\u2010Pescara  Chieti Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3724-1495","authenticated-orcid":false,"given":"Francesco","family":"Chiarelli","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Pediatric Allergy and Pulmonology Unit University of Chieti\u2010Pescara  Chieti Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6513-3160","authenticated-orcid":false,"given":"Marina","family":"Attanasi","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Pediatric Allergy and Pulmonology Unit University of Chieti\u2010Pescara  Chieti Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,28]]},"reference":[{"issue":"6","key":"e_1_2_13_2_1","doi-asserted-by":"crossref","first-page":"389","DOI":"10.2500\/aap.2019.40.4254","article-title":"Pediatric Asthma: Principles and Treatment","volume":"40","author":"Devonshire A. L.","year":"2019","journal-title":"Allergy and Asthma Proceedings"},{"issue":"10","key":"e_1_2_13_3_1","doi-asserted-by":"crossref","DOI":"10.3390\/children11101232","article-title":"Acute Respiratory Failure in Children: A Clinical Update on Diagnosis","volume":"11","author":"Panetti B.","year":"2024","journal-title":"Children"},{"issue":"4","key":"e_1_2_13_4_1","article-title":"Time\u2010Specific Factors Influencing the Development of Asthma in Children","volume":"10","author":"Russo D.","year":"2022","journal-title":"Biomedicine"},{"issue":"3","key":"e_1_2_13_5_1","doi-asserted-by":"crossref","first-page":"646","DOI":"10.1016\/j.jaci.2012.12.1567","article-title":"Small\u2010Airways Dysfunction Associates With Respiratory Symptoms and Clinical Features of Asthma: A Systematic Review","volume":"131","author":"Van der Wiel E.","year":"2013","journal-title":"Journal of Allergy and Clinical Immunology"},{"issue":"1","key":"e_1_2_13_6_1","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1007\/s12016-020-08818-1","article-title":"Small Airway Disease in Pediatric Asthma","volume":"62","author":"Hopp R. J.","year":"2022","journal-title":"Clinical Reviews in Allergy & Immunology"},{"key":"e_1_2_13_7_1","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1186\/s40413-017-0153-4","article-title":"Small Airways Disease and Severe Asthma","volume":"10","author":"Carr T. F.","year":"2017","journal-title":"World Allergy Organization Journal"},{"issue":"2","key":"e_1_2_13_8_1","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1097\/ACI.0000000000000728","article-title":"Small\u2010Airway Dysfunction in Paediatric Asthma","volume":"21","author":"Cottini M.","year":"2021","journal-title":"Current Opinion in Allergy and Clinical Immunology"},{"key":"e_1_2_13_9_1","doi-asserted-by":"crossref","DOI":"10.3402\/ecrj.v1.25898","article-title":"Techniques of Assessing Small Airways Dysfunction","volume":"1","author":"McNulty W.","year":"2014","journal-title":"European Clinical Respiratory Journal"},{"issue":"6","key":"e_1_2_13_10_1","first-page":"1324","article-title":"Multi\u2010Ethnic Reference Values for Spirometry for the 3\u201395\u2010Yr Age Range","volume":"40","author":"Quanjer P. H.","year":"2012","journal-title":"European Respiratory Journal"},{"issue":"3","key":"e_1_2_13_11_1","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1016\/j.jaci.2010.05.016","article-title":"Forced Expiratory Flow Between 25% and 75% of Vital Capacity in Asthmatic Children With Normal FEV1","volume":"126","author":"Simon M. R.","year":"2010","journal-title":"Journal of Allergy and Clinical Immunology"},{"issue":"6","key":"e_1_2_13_12_1","doi-asserted-by":"crossref","first-page":"586","DOI":"10.3109\/02770903.2012.690481","article-title":"The Utility of Forced Expiratory Flow Between 25% and 75% of Vital Capacity","volume":"49","author":"Rao D. R.","year":"2012","journal-title":"Journal of Asthma"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.23750\/abm.v94i1.14678"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.2500\/aap.2012.33.3524"},{"issue":"6","key":"e_1_2_13_15_1","doi-asserted-by":"crossref","first-page":"664","DOI":"10.1016\/j.anai.2017.04.009","article-title":"The Case for Impulse Oscillometry in the Management of Asthma","volume":"118","author":"Galant S. P.","year":"2017","journal-title":"Annals of Allergy, Asthma & Immunology"},{"issue":"2","key":"e_1_2_13_16_1","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1016\/j.iac.2018.12.002","article-title":"Recent Diagnosis Techniques in Pediatric Asthma","volume":"39","author":"McDowell K. M.","year":"2019","journal-title":"Immunology and Allergy Clinics of North America"},{"key":"e_1_2_13_17_1","first-page":"9","article-title":"Impulse Oscillometry (IOS): A New Lung Function Test in Children With Asthma","volume":"8","author":"Comberiati P.","year":"2021","journal-title":"Rivista Italiana di Pediatria Ospedaliera"},{"issue":"2","key":"e_1_2_13_18_1","doi-asserted-by":"crossref","DOI":"10.1183\/13993003.00753-2019","article-title":"Technical Standards for Respiratory Oscillometry","volume":"55","author":"King G. G.","year":"2020","journal-title":"European Respiratory Journal"},{"issue":"3","key":"e_1_2_13_19_1","doi-asserted-by":"crossref","first-page":"671","DOI":"10.1016\/j.jaci.2011.11.002","article-title":"Relating Small Airways to Asthma Control by Impulse Oscillometry in Children","volume":"129","author":"Shi Y.","year":"2012","journal-title":"Journal of Allergy and Clinical Immunology"},{"issue":"2","key":"e_1_2_13_20_1","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1159\/000442448","article-title":"Impulse Oscillometry as a Predictor of Asthma Exacerbations in Young Children","volume":"91","author":"Schulze J.","year":"2016","journal-title":"Respiration"},{"issue":"5","key":"e_1_2_13_21_1","doi-asserted-by":"crossref","DOI":"10.1183\/13993003.04173-2020","article-title":"European Respiratory Society Clinical Practice Guidelines for the Diagnosis of Asthma in Children Aged 5\u201316\u2009Years","volume":"58","author":"Gaillard E. A.","year":"2021","journal-title":"European Respiratory Journal"},{"key":"e_1_2_13_22_1","unstructured":"Global Initiative for Asthma \u201cGINA Strategy Report 2025. Global Strategy for Asthma Management and Prevention \u201d(2025)."},{"key":"e_1_2_13_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.71362"},{"key":"e_1_2_13_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2011.12.962"},{"issue":"8","key":"e_1_2_13_25_1","doi-asserted-by":"crossref","first-page":"e70","DOI":"10.1164\/rccm.201908-1590ST","article-title":"Standardization of Spirometry 2019 Update. An Official American Thoracic Society and European Respiratory Society Technical Statement","volume":"200","author":"Graham B. L.","year":"2019","journal-title":"American Journal of Respiratory and Critical Care Medicine"},{"key":"e_1_2_13_26_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.13\u20101875"},{"key":"e_1_2_13_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/s2213\u20102600(14)70103\u20101"},{"key":"e_1_2_13_28_1","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.03369\u20102020"},{"key":"e_1_2_13_29_1","doi-asserted-by":"publisher","DOI":"10.2500\/aap.2013.34.3641"},{"key":"e_1_2_13_30_1","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2022.877681"},{"key":"e_1_2_13_31_1","doi-asserted-by":"publisher","DOI":"10.1111\/pai.70208"},{"issue":"5","key":"e_1_2_13_32_1","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1016\/j.aller.2017.09.028","article-title":"Asthma Predictive Index in Relation to Respiratory Mechanics by Impulse Oscillometry in Recurrent Wheezers","volume":"46","author":"Arikoglu T.","year":"2018","journal-title":"Allergologia et Immunopathologia"},{"key":"e_1_2_13_33_1","doi-asserted-by":"publisher","DOI":"10.1183\/20734735.020514"},{"key":"e_1_2_13_34_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.24790"},{"key":"e_1_2_13_35_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.25374"},{"issue":"4","key":"e_1_2_13_36_1","doi-asserted-by":"crossref","first-page":"599","DOI":"10.1016\/S0272-5231(05)70055-1","article-title":"Tests of Forced Expiration and Inspiration","volume":"22","author":"Pride N. B.","year":"2001","journal-title":"Clinics in Chest Medicine"},{"key":"e_1_2_13_37_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.rmed.2020.106243","article-title":"Prevalence and Features of IOS\u2010Defined Small Airway Disease Across Asthma Severities","volume":"176","author":"Cottini M.","year":"2021","journal-title":"Respiratory Medicine"},{"issue":"5","key":"e_1_2_13_38_1","doi-asserted-by":"crossref","first-page":"552","DOI":"10.1002\/ppul.23977","article-title":"Impulse Oscillometry at Preschool Age Is a Strong Predictor of Lung Function by Flow\u2010Volume Spirometry in Adolescence","volume":"53","author":"Lauhkonen E.","year":"2018","journal-title":"Pediatric Pulmonology"},{"key":"e_1_2_13_39_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.26333"}],"container-title":["Acta Paediatrica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/apa.70763","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/apa.70763","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/apa.70763","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T09:42:19Z","timestamp":1790588539000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/apa.70763"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,28]]},"references-count":38,"alternative-id":["10.1111\/apa.70763"],"URL":"https:\/\/doi.org\/10.1111\/apa.70763","archive":["Portico"],"relation":{},"ISSN":["0803-5253","1651-2227"],"issn-type":[{"value":"0803-5253","type":"print"},{"value":"1651-2227","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,28]]},"assertion":[{"value":"2026-06-05","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-08","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-28","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"apa.70763"}}