Bronchodilator response testing in pediatric asthma patients
Bibliographic record
Abstract
Introduction: The clinical impact of routine spirometry with bronchodilator response (BDR) testing in pediatric asthma patients treated with inhaled corticosteroid (ICS) or ICS/long acting beta-agonist therapy (ICS/LABA), is not well known. The purpose of this study was to determine the characteristic spirometry patterns in pediatric patients with treated asthma, and the added clinical value of BDR testing. Methods: Retrospective review of spirometry tests performed for a clinical diagnosis of asthma in patients treated with ICS or ICS/LABA at the Hospital for Sick Children, Toronto, from January 1, 2020 to December 25, 2023. Results: 1015 spirometries with BDR testing in children with a median age of 12.2 (IQR 9.3-15.2) years were included. 546 were normal (54%), 274 (27%) showed an obstructive ventilatory defect with insignificant BDR, and 124 (12%) obstruction with significant BDR, according to ATS criteria. 771 (64%) patients were on ICS/LABA at the time of testing. The frequency of obstruction with insignificant BDR was similar between patients on ICS/LABA or on ICS (27% vs. 25%). In patients on ICS/LABA with insignificant BDR, 42% who underwent scoring by asthma control questionnaire (ACQ) had uncontrolled asthma, and 42% who performed exhaled nitric oxide (eNO) testing had an eNO ≥25ppb. Conclusions: The two most common patterns on spirometry in treated pediatric asthma patients were normal and obstructive ventilatory defect with insignificant BDR. However, in patients treated with ICS/LABA insignificant BDR did not correlate well with ACQ scores or eNO. The clinical utility of routine BDR testing in children with treated asthma may be low and may require a greater level of caution when used to guide therapy.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 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 source (direct Gemma or distilled Codex), 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".