Physiological tests of small airways function in diagnosing asthma: a systematic review.
Physiological tests of small airways function in diagnosing asthma: a systematic review.
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DOI：
10.1136/bmjresp-2020-000770
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发表时间：
2020-12
影响因子：
4.1
通讯作者：
Sapey E
中科院分区：
文献类型：
--
作者：
Almeshari MA;Alobaidi NY;Edgar RG;Stockley J;Sapey E
哮喘是一种常见的异质性疾病，其特征是慢性气道炎症和可变的呼气气流受限。目前的指南使用肺活量测量来评估哮喘。本系统评价旨在评估最常报告的小气道功能测试是否有助于哮喘的诊断。使用标准系统评价方法，并检索了一系列电子数据库（Embase、MEDLINE、CINAHL、CENTRAL、Web of Science、DARE）。包括通过小气道功能的生理测试来诊断成人哮喘的研究，没有语言或日期的限制。使用的偏倚风险和质量评估工具是用于横断面研究的医疗保健研究机构和质量工具以及用于诊断测试准确性（DTA）研究的诊断准确性研究质量评估2。共确定了 7072 项研究，其中 10 项研究符合审查标准。 7 项包括振荡技术，5 项包括最大呼气中期流量 (MMEF)。研究规模较小且质量参差不齐。在示波法中，与健康对照相比，哮喘患者的总电阻 (R5) 和 5 Hz 电抗 (X5) 发生了变化。在所有研究中，与对照组相比，哮喘患者的 MMEF 预测百分比较低，并且低于 1 秒内用力呼气量的预测百分比。在示波DTA中，R5的敏感性为69%至72%，特异性为61%至86%。哮喘患者小气道功能生理测试结果与对照组存在差异。然而，研究规模较小且异质性强。需要进一步的研究来更大规模地评估这些测试的有效性，包括确定哪种测试方法对哮喘最有用的研究。
Asthma is a common, heterogeneous disease that is characterised by chronic airway inflammation and variable expiratory airflow limitation. Current guidelines use spirometric measures for asthma assessment. This systematic review aimed to assess whether the most commonly reported tests of small airways function could contribute to the diagnosis of asthma. Standard systematic review methodology was used, and a range of electronic databases was searched (Embase, MEDLINE, CINAHL, CENTRAL, Web of Science, DARE). Studies that included physiological tests of small airways function to diagnose asthma in adults were included, with no restrictions on language or date. The risk of bias and quality assessment tools used were Agency for Healthcare Research and Quality tool for cross-sectional studies and Quality Assessment of Diagnostic Accuracy Studies 2 for diagnostic test accuracy (DTA) studies. 7072 studies were identified and 10 studies met review criteria. 7 included oscillation techniques and 5 included maximal mid-expiratory flow (MMEF). Studies were small and of variable quality. In oscillometry, total resistance (R5) and reactance at 5 Hz (X5) was altered in asthma compared with healthy controls. The percentage predicted of MMEF was lower in patients with asthma compared with controls in all studies and lower than the % predicted forced expiratory volume in 1 s. In DTA of oscillometry, R5 showed a sensitivity between 69% and 72% and specificity between 61% and 86%. There were differences in the results of physiological tests of small airway function in patients with asthma compared with controls. However, studies are small and heterogeneous. Further studies are needed to assess the effectiveness of these tests on a larger scale, including studies to determine which test methodology is the most useful in asthma.
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DOI：
10.1136/bmj.b2535
发表时间：
2009-07-21
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Moher D;Liberati A;Tetzlaff J;Altman DG;PRISMA Group
通讯作者：
PRISMA Group
影响因子：
12.4
作者：
Bourdin, A;Paganin, F;Chanez, P
通讯作者：
Chanez, P
DOI：
10.1016/j.apmr.2006.06.015
发表时间：
2006-10-01
影响因子：
4.3
作者：
Jain, Nitin B.;Brown, Robert;Garshick, Eric
通讯作者：
Garshick, Eric
影响因子：
5.8
作者：
Mendonça NT;Kenyon J;LaPrad AS;Syeda SN;O'Connor GT;Lutchen KR
通讯作者：
Lutchen KR
影响因子：
24.3
作者：
Oostveen, Ellie;Boda, Krisztina;Hantos, Zoltan
通讯作者：
Hantos, Zoltan