{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T04:15:59Z","timestamp":1747196159096,"version":"3.40.5"},"reference-count":38,"publisher":"Public Library of Science (PLoS)","issue":"5","license":[{"start":{"date-parts":[[2022,5,26]],"date-time":"2022-05-26T00:00:00Z","timestamp":1653523200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:p>The current cut-off value for diagnosing exercise-induced bronchoconstriction (EIB) in adults\u2014percent fall in FEV<jats:sub>1<\/jats:sub>(\u0394FEV<jats:sub>1<\/jats:sub>) \u2265 10% after exercise challenge test (ECT)\u2014has low specificity and weak evidences. Therefore, this study aimed to identify the cut-off value for EIB that provides the highest diagnostic sensitivity and specificity. Participants who underwent the ECT between 2007 and 2018 were categorized according to \u0394FEV<jats:sub>1<\/jats:sub>: definite EIB (\u0394FEV<jats:sub>1<\/jats:sub>\u2265 15%), borderline (10% \u2264 \u0394FEV<jats:sub>1<\/jats:sub>&lt; 15%), and normal (\u0394FEV<jats:sub>1<\/jats:sub>&lt; 10%). Distinct characteristics of the definite EIB group were identified and explored in the borderline EIB group. A receiver operating characteristic curve was plotted to determine the optimal cut-off value. Of 128 patients, 60 were grouped as the definite EIB group, 23 as the borderline group, and 45 as the normal group. All participants were men, with a median age of 20 years (interquartile range [IQR:] 19\u201323 years). The definite EIB group exhibited wheezing on auscultation (<jats:italic>P<\/jats:italic>&lt; 0.001), \u0394FEV<jats:sub>1<\/jats:sub>\/FVC \u2265 10% (<jats:italic>P<\/jats:italic>&lt; 0.001), and \u0394FEF<jats:sub>25\u201375%<\/jats:sub>\u2265 25% (<jats:italic>P<\/jats:italic>&lt; 0.001) compared to other groups. Eight (8\/23, 34.8%) patients in the borderline group had at least one of these features, but the trend was more similar to that of the normal group than the definite EIB group. A cut-off value of \u0394FEV<jats:sub>1<\/jats:sub>\u2265 13.5% had a sensitivity of 98.5% and specificity of 93.5% for EIB. Wheezing on auscultation, \u0394FEV<jats:sub>1<\/jats:sub>\/FVC \u2265 10%, and \u0394FEF<jats:sub>25\u201375%<\/jats:sub>\u2265 25% after ECT may be useful for the diagnosis of EIB, particularly in individuals with a \u0394FEV<jats:sub>1<\/jats:sub>of 10\u201315%. For EIB, a higher cut-off value, possibly \u0394FEV<jats:sub>1<\/jats:sub>\u2265 13.5%, should be considered as the diagnostic criterion.<\/jats:p>","DOI":"10.1371\/journal.pone.0268969","type":"journal-article","created":{"date-parts":[[2022,5,26]],"date-time":"2022-05-26T17:30:39Z","timestamp":1653586239000},"page":"e0268969","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["Cut-off value for exercise-induced bronchoconstriction based on the features of the airway obstruction"],"prefix":"10.1371","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0925-3891","authenticated-orcid":true,"given":"Noeul","family":"Kang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eunsil","family":"Koh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jin-Young","family":"Lee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Woo-Jung","family":"Song","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dong-Chull","family":"Choi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6940-0836","authenticated-orcid":true,"given":"Byung-Jae","family":"Lee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2022,5,26]]},"reference":[{"key":"pone.0268969.ref001","doi-asserted-by":"crossref","first-page":"1292","DOI":"10.1016\/j.jaci.2016.05.029","article-title":"Exercise-induced bronchoconstriction update-2016","volume":"138","author":"JM Weiler","year":"2016","journal-title":"J Allergy Clin Immunol"},{"key":"pone.0268969.ref002","doi-asserted-by":"crossref","first-page":"352","DOI":"10.1164\/ajrccm.149.2.8306029","article-title":"Bronchoconstriction occurring during exercise in asthmatic subjects","volume":"149","author":"KC Beck","year":"1994","journal-title":"Am J Respir Crit Care Med"},{"key":"pone.0268969.ref003","doi-asserted-by":"crossref","first-page":"1362","DOI":"10.1056\/NEJM199405123301907","article-title":"Exercise-induced asthma","volume":"330","author":"ER McFadden","year":"1994","journal-title":"N Engl J Med"},{"key":"pone.0268969.ref004","doi-asserted-by":"crossref","first-page":"1016","DOI":"10.1164\/rccm.201303-0437ST","article-title":"An official American Thoracic Society clinical practice guideline: exercise-induced bronchoconstriction","volume":"187","author":"JP Parsons","year":"2013","journal-title":"Am J Respir Crit Care Med"},{"key":"pone.0268969.ref005","doi-asserted-by":"crossref","first-page":"1487","DOI":"10.1249\/mss.0b013e3180986e45","article-title":"Prevalence of exercise-induced bronchospasm in a cohort of varsity college athletes","volume":"39","author":"JP Parsons","year":"2007","journal-title":"Med Sci Sports Exerc"},{"key":"pone.0268969.ref006","doi-asserted-by":"crossref","first-page":"1349","DOI":"10.1016\/j.jaci.2007.02.041","article-title":"American Academy of Allergy, Asthma & Immunology Work Group report: exercise-induced asthma","volume":"119","author":"JM Weiler","year":"2007","journal-title":"J Allergy Clin Immunol"},{"key":"pone.0268969.ref007","unstructured":"Global Initiative for Asthma. 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