Relation of airway responsiveness to methacholine to parent and child reporting of symptoms suggesting asthma: RESULTS Part 5
These analyses were repeated using only symptoms reported as current, ie, occurring in the past 12 months before testing (Figure 2). Parent-reported physician-diagnosed asthma with current symptoms was highly correlated with airway responsiveness (Figure 2A; P=0.038), although wheezing not diagnosed as asthma was not (P=1.0). There were no significant increases in area under the ROC curve for any current wheezing (Figure 2C; P=0.175) or for any current respiratory symptom (P=0.172). When confined to the child questionnaire only, diagnosed asthma with current symptoms (Figure 2B; P=0.009) was correlated with airway responsiveness, but wheezing not diagnosed as asthma was not (P=0.485). The combination of child and parent reports of current symptoms reduced rather than increased the level of significance for the areas under the ROC curves; diagnosed asthma (P=0.076), any wheezing (Figure 2D; P=0.174) and the reporting of any respiratory symptom (P=0.179) were no longer significant.
From the ROC diagrams, the optimum sensitivity and specificity ofmethacholine testing being considered positive were obtained with PC20 between 4.0 and 8.0 mg/mL for asthma and for wheezing, whether or not diagnosed as asthma, for both the parental report and the child report of symptoms.
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Figure 2) Receiver operating characteristic curves for sensitivity (y-axis) and 1-specificity (x-axis) of airway ‘hyperresponsiveness’ at cut-points for provocation concentration of methacholine causing a 20% fall in forced expired volume in 1 s of <1 (far left), <2, <4, <8 and <16 mg/mL and any result (far right) for parental and child reports of diagnoses and symptoms, with episodes occurring in the past year (‘current’). A Current physician-diagnosed asthma (parent-reported) (P=0.038). B Current asthma reported by child (P=0.009). C Current asthma and/or wheezing (parent-reported) (P=0.175). D Current asthma and/or wheezing reported by parent or child (P=0.174)