Impact of inhaled corticosteroids on specific inhalation challenges for diagnosing occupational asthma
Bibliographic record
Abstract
<b>Introduction:</b> Use of inhaled corticosteroids (ICS) prior to allergen inhalation challenge can blunt the asthmatic reaction. Thus, guidelines on occupational asthma (OA) suggest discontinuing ICS 72h before testing. However, there is little real-world data on their impact on the results of specific inhalation challenges (SIC). <b>Aims and objectives:</b> To assess the impact of ongoing treatment with ICS on the maximum fall in FEV1 and the change in airway responsiveness following exposure to the offending agent <b>Methods:</b> We conducted a retrospective study using a database of 671 subjects who underwent SIC in our laboratory between 1999 and 2022. The database comprises clinical and functional data. The total dose of ICS was administered 12h before each day of testing. Logistic and linear regression models were used to assess the effects of ICS on the maximum fall in FEV1 and the change in PC20 after SIC while controlling for confounders. <b>Results:</b> 671 subjects were assessed. 318 were taking a mean (±SD) of 653 (±338) mcg of ICS and 353 were steroid naïve. Subjects taking ICS had lower baseline FEV1 and PC20. 223 (33%) subjects had a positive SIC. The mean maximum fall in FEV1 after exposure was higher in subjects with ICS (13.1±11.4%) than in steroid naïve subjects (10.9±11.5%) p=0.015. Change in PC20 after exposure was similar in both groups. ICS did not appear to be a significant factor influencing the maximum fall in FEV1 (OR 1.55 95% CI 0.96-2.50) or change in PC20 (OR 0.96 95% CI 0.60-1.31) after SIC. <b>Conclusion:</b> Ongoing treatment with ICS during SIC does not appear to reduce the maximum fall in FEV1 or change in airway responsiveness. ICS can be continued during SIC without affecting the results.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".