12 May 2017
ERS technical standard on bronchial challenge testing: general considerations and performance of methacholine challenge tests.
A new paper by ERS published on the ERJ aims to update previous publications on bronchial challenge testing and the performance of the methacholine challenge test.
This report focuses on general considerations for bronchial challenge testing, then specifically on the performance of the methacholine challenge test (MCT).
Direct airway challenges with methacholine are proposed as a diagnostic aid, to increase or decrease the probability of asthma. Evaluation of the test performance is hampered by the lack of an independent gold standard for objective confirmation of asthma. Nevertheless, the following approach is recommended. The optimal diagnostic value of methacholine challenge testing occurs when the pre-test probability of asthma is 30–70%. Methacholine challenge testing is more useful in excluding a diagnosis of asthma than in establishing one because its negative predictive value, when respiratory symptoms are present, is greater than its positive predictive value.
The article details are the following:
- Title: "ERS technical standard on bronchial challenge testing: general considerations and performance of methacholine challenge tests"
- Authors: Coates AL, Wanger J, Cockcroft DW, Culver BH; and the Bronchoprovocation Testing Task Force: Kai-Håkon Carlsen, Diamant Z, Gauvreau G, Hall GL, Hallstrand TS, Horvath I, de Jongh FHC, Joos G, Kaminsky DA, Laube BL, Leuppi JD, Sterk PJ
- Published in: Eur Respir J. 2017 May 1;49(5)
The study can be freely downloaded at the following link: click here