{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T06:05:52Z","timestamp":1775628352307,"version":"3.50.1"},"reference-count":27,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2022,1,18]],"date-time":"2022-01-18T00:00:00Z","timestamp":1642464000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Respir Care"],"published-print":{"date-parts":[[2022,6]]},"abstract":"\n BACKGROUND:<\/jats:title>\n There are several tests recommended by the American Thoracic Society (ATS) to evaluate for airway hyper-responsiveness (AHR), one of which is methacholine challenge testing (MCT). Few studies have examined the correlation of baseline spirometry to predict AHR in MCT, especially in the younger, relatively healthy military population under clinical evaluation for symptoms of exertional dyspnea. The study aim was to retrospectively correlate baseline spirometry values with MCT responsiveness.<\/jats:p>\n <\/jats:sec>\n \n METHODS:<\/jats:title>\n \n This study is a retrospective review of all MCT performed at Brooke Army Medical Center\/Wilford Hall Medical Center over a 12-y period; all completed studies were obtained from electronic databases. The following parameters were analyzed from the studies: baseline FEV\n 1<\/jats:sub>\n , FVC, FEV\n 1<\/jats:sub>\n \/FVC, mid-expiratory flow (FEV\n 25-75%<\/jats:sub>\n ), FEV\n 25\u201375%<\/jats:sub>\n \/FVC. Studies were categorized based on baseline obstruction, restriction, FEF\n 25\u201375%<\/jats:sub>\n lower limit of normal, and response to bronchodilator testing (if completed); these values were compared based on methacholine reactivity and severity.\n <\/jats:p>\n <\/jats:sec>\n \n RESULTS:<\/jats:title>\n \n Methacholine challenge studies (\n n =<\/jats:italic>\n 1,933) were reviewed and categorized into reactive (\n n =<\/jats:italic>\n 577) and nonreactive (\n n =<\/jats:italic>\n 1,356) as determined by ATS guidelines. The mean baseline FEV\n 1<\/jats:sub>\n (% predicted) with MCT reactivity was 88.0 \u00b1 13.0% versus no MCT reactivity was 92.7 \u00b1 13.0% (\n P<\/jats:italic>\n < .001). The mean baseline FVC (% predicted) was 93.1 \u00b1 13.7% versus 95.3 \u00b1 13.5% (\n P<\/jats:italic>\n < .001). The mean baseline FEV\n 25\u201375%<\/jats:sub>\n (% predicted) was 80.0 \u00b1 22.1% versus 89.0 \u00b1 23.4% (\n P<\/jats:italic>\n < .001). Based on partition analysis, methacholine reactivity was most prevalent with baseline obstruction,\n n =<\/jats:italic>\n 115 (43%), and in the absence of obstruction, when the FEF\n 25\u201375%<\/jats:sub>\n (% predicted) was below 0.70,\n n =<\/jats:italic>\n 111 (40%). The negative predictive value with normal spirometry was 73%.\n <\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS:<\/jats:title>\n \n The analysis of baseline spirometry prior to MCT proved useful in the evaluation of exertional dyspnea in a military population. The presence of airways obstruction (FEV\n 1<\/jats:sub>\n \/FVC < lower limit of the normal range) followed by a reduction in FEV\n 25\u201375%<\/jats:sub>\n < 70% predicted showed a positive correlation with underlying AHR. In patients with exertional dyspnea and normal baseline spirometry, the use of the FEF\n 25\u201375%<\/jats:sub>\n may be a useful surrogate measurement to predict reactivity during MCT and consideration for additional testing or treatment\n <\/jats:p>\n <\/jats:sec>","DOI":"10.4187\/respcare.09163","type":"journal-article","created":{"date-parts":[[2022,1,18]],"date-time":"2022-01-18T14:45:52Z","timestamp":1642517152000},"page":"694-701","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Baseline Spirometry as a Predictor of Positive Methacholine Challenge Testing for Exertional Dyspnea"],"prefix":"10.1177","volume":"67","author":[{"given":"John C","family":"Hunninghake","sequence":"first","affiliation":[{"name":"Pulmonary\/Critical Care Service, Department of Medicine, Brooke Army Medical Center, JBSA Fort Sam Houston, Texas."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah B","family":"McCullough","sequence":"additional","affiliation":[{"name":"Wake Forest Baptist Medical Center, Winston-Salem, North Carolina."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James K","family":"Aden","sequence":"additional","affiliation":[{"name":"Graduate Medical Education, Brooke Army Medical Center, JBSA Fort Sam Houston, Texas."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jackie A","family":"Hayes","sequence":"additional","affiliation":[{"name":"Pulmonary\/Critical Care Service, Department of Medicine, Brooke Army Medical Center, JBSA Fort Sam Houston, Texas."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edward T","family":"McCann","sequence":"additional","affiliation":[{"name":"Pulmonary\/Critical Care Service, Department of Medicine, Brooke Army Medical Center, JBSA Fort Sam Houston, Texas."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael J","family":"Morris","sequence":"additional","affiliation":[{"name":"Pulmonary\/Critical Care Service, Department of Medicine, Brooke Army Medical Center, JBSA Fort Sam Houston, Texas."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2022,1,18]]},"reference":[{"issue":"1","key":"e_1_3_2_2_2","first-page":"309","article-title":"Guidelines for methacholine and exercise challenge testing-1999","volume":"161","author":"American Thoracic Society","year":"1999","unstructured":"American Thoracic Society. Guidelines for methacholine and exercise challenge testing-1999. Am J Respir Crit Care Med, 19992000;161(1):309-329.","journal-title":"Am J Respir Crit Care Med"},{"issue":"2","key":"e_1_3_2_3_2","first-page":"265","article-title":"Bronchial challenge testing","volume":"1","author":"Irvin CG","year":"1995","unstructured":"Irvin CG. Bronchial challenge testing. Respir Care Clin N Am, 1995; 1(2):265-285.","journal-title":"Respir Care Clin N Am"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.103.3.742"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1093\/milmed\/167.4.281"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1081\/JAS-120037656"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.119.3.701"},{"key":"e_1_3_2_8_2","volume-title":"Standards of Medical Fitness","author":"Army Regulation 40\u2013501","year":"2016","unstructured":"Army Regulation 40\u2013501. Standards of Medical Fitness. 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