Relation of Changes in PEF and FEV 1 During Salbutamol‐Induced Bronchodilation After Methacholine Challenge Test
Year: 2025
Type: article
Abstract: Asthma diagnosis can be confirmed by observing significant bronchodilator response (BDR) through peak expiratory flow (PEF) at home or forced expiratory volume in 1 s (FEV 1 ) via spirometry in a clinical setting. We aimed to use the administration of salbutamol after a methacholine challenge test as a model of bronchodilation to study how accurately the change in PEF predicts improvement in lung function, as defined by an increase in FEV 1 . We analyzed 869 adult patients who were administered salbutamol after a methacholine challenge. To compare relative changes in PEF and FEV 1 during bronchodilation, we used regression analysis and constructed a Bland and Altman plot. ROC analysis, sensitivity, specificity, positive and negative predictive values, and kappa coefficient assessed how precisely increases in PEF detected a 12% and 0.2‐L improvement in FEV 1 . The average relative increase in FEV 1 was significantly greater than that in PEF. The area under the curve in the ROC analysis was 0.844 for PEF change to detect a 12% and 0.2‐L increase in FEV 1 . The kappa values for changes in PEF and FEV 1 ranged from fair to moderate. BDR detected by the recommended 15% and 60 L/min cut‐off for PEF identified less than half of true positives, while a 10% cut‐off correctly identified close to 75% of them. PEF increase is not a reliable measure of BDR in comparison to FEV 1 increase, and a 10% improvement in PEF was the least inaccurate cut‐off. Substituting the PEF meter with a handheld spirometer should be further investigated for asthma home monitoring.
Source: Pulmonary Medicine
DOI: 10.1155/pm/7675935
Language: English
Subfield: Physiology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $1,000
OpenAlex ID: W4412473609