{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T09:57:51Z","timestamp":1775469471466,"version":"3.50.1"},"reference-count":26,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2023,4,1]],"date-time":"2023-04-01T00:00:00Z","timestamp":1680307200000},"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":[[2023,4]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>\n                      Spirometry tests with a bronchodilator response (BDR) in FEV\n                      <jats:sub>1,<\/jats:sub>\n                      a methacholine concentration that produces a 20% drop in FEV\n                      <jats:sub>1<\/jats:sub>\n                      (PC\n                      <jats:sub>20<\/jats:sub>\n                      ) \u2264 2 mg\/mL, and a positive exercise test have high specificity for the diagnosis of asthma in children. However, the value of forced expiratory flow during the middle half of the FVC maneuver (FEF\n                      <jats:sub>25\u201375<\/jats:sub>\n                      ) in spirometry has been questioned. The objective of this study was to relate the BDR in FEF\n                      <jats:sub>25\u201375<\/jats:sub>\n                      of spirometry tests with normal FEV\n                      <jats:sub>1<\/jats:sub>\n                      and FEV\n                      <jats:sub>1<\/jats:sub>\n                      \/FVC to airway hyper-responsiveness (AHR) to methacholine or exercise in children age 5\u201315 y with clinical suspicion of asthma.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>This was a cross-sectional study of spirometry tests performed between January 2017\u2013December 2019 in children age 5\u201315 y with diagnostic suspicion of asthma who had a methacholine and\/or exercise testing within a period not exceeding 60 d between exams.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      The mean (\u00b1 SD) age of the children was 9.04 \u00b1 2.67 y, with a range of 5\u201315 y, and 56.17% were male. Of the 324 spirometry tests with normal FEV\n                      <jats:sub>1<\/jats:sub>\n                      and FEV\n                      <jats:sub>1<\/jats:sub>\n                      \/FVC, 66 (20.4%) tests showed BDR in FEF\n                      <jats:sub>25\u201375<\/jats:sub>\n                      . A total of 46.9% and 33.3% of the children with and without BDR in FEF\n                      <jats:sub>25\u201375<\/jats:sub>\n                      , respectively, had a PC\n                      <jats:sub>20<\/jats:sub>\n                      value \u2264 2 mg\/mL and\/or a positive exercise testing (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .039).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>\n                      Children with suspected asthma and normal spirometry, other than BDR in FEF\n                      <jats:sub>25\u201375<\/jats:sub>\n                      , had greater AHR than those without BDR in FEF\n                      <jats:sub>25\u201375<\/jats:sub>\n                      . BDR in FEF\n                      <jats:sub>25\u201375<\/jats:sub>\n                      was not always accompanied by AHR to confirm the diagnosis of asthma, so this study suggests that assessment of FEF\n                      <jats:sub>25\u201375<\/jats:sub>\n                      alone is not always reliable for ruling in or ruling out AHR in the setting of otherwise normal spirometry results in children with suspected asthma.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.4187\/respcare.10177","type":"journal-article","created":{"date-parts":[[2023,3,24]],"date-time":"2023-03-24T22:55:15Z","timestamp":1679698515000},"page":"505-510","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Bronchodilator Response in FEF\n                    <sub>25\u201375<\/sub>\n                    for the Diagnosis of Asthma in Children"],"prefix":"10.1177","volume":"68","author":[{"given":"Marcela B","family":"Linares","sequence":"first","affiliation":[{"name":"Cl\u00ednica INDISA, Santiago, Chile."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mar\u00eda Angelica","family":"Rodr\u00edguez","sequence":"additional","affiliation":[{"name":"Pulmonary Function Laboratory, Cl\u00ednica INDISA, Santiago, Chile."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Danae M","family":"Icarte","sequence":"additional","affiliation":[{"name":"Centro de Salud Familiar El Belloto, Servicio de Salud Vi\u00f1a del Mar, Quillota, Valpara\u00edso, Chile."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bitter A","family":"Mart\u00ednez","sequence":"additional","affiliation":[{"name":"Centro de Salud Familiar El Belloto SUR, Servicio de Salud Valpara\u00edso, Valpara\u00edso, Chile; and Hospital Cl\u00ednico Universidad de Chile, Santiago, Chile."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valentina P","family":"Milla","sequence":"additional","affiliation":[{"name":"Centro de Salud Familiar El Belloto SUR, Servicio de Salud Valpara\u00edso, Valpara\u00edso, Chile; and Universidad Finis Terrae, Santiago, Chile."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Noelia F","family":"Zygier","sequence":"additional","affiliation":[{"name":"Escuela de Medicina, Universidad Andr\u00e9s Bello; Research Unit, Cl\u00ednica INDISA, Santiago, Chile."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claudio R","family":"Olmos","sequence":"additional","affiliation":[{"name":"Escuela de Medicina, Universidad Andre\u2019s Bello; Research Unit, Cli\u00ednica INDISA, Santiago, Chile."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2023,4,1]]},"reference":[{"key":"e_1_3_2_2_2","unstructured":"Global Initiative for Asthma - GINA. 2020 GINA Main Report. 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The role of objective tests to support a diagnosis of asthma in children. Paediatr Respir Rev, 2020; 33:52-57.","journal-title":"Paediatr Respir Rev"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1111\/resp.12349"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.2147\/JAA.S318502"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaip.2021.06.027"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.01499-2021"},{"issue":"3","key":"e_1_3_2_27_2","first-page":"295","article-title":"FEF25\u201375% and asthma in clinical practice","volume":"17","author":"Ciprandi G","year":"2018","unstructured":"Ciprandi G, , Gallo F, , Cirillo I. FEF25\u201375% and asthma in clinical practice. 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