VG
VG
PPV for diagnosing asthma
NPV for diagnosing asthma
VG
Fair
Fair
PPV for diagnosing EIB
D
Yes
No
No
Correlates with airway inflammation
Produces dose-response curve
Requires subjects to be capable of exertion
(eg, relatively free of cardiac disease)
Causes severe decreases in FEV1
(eg, greater than 30%)
No
No
Yes
MI
D
Yes
Yes
No
H
ID
VG
VG
E
VG-E
Fair
VG
VG
Good
Yes
Yes
No
H
ID
VG
VG
E
VG-E
Fair
VG
VG
Good
Yes
No
No
H
ID
VG
VG
E
VG-E
Fair
VG
VG
Good
VG
Fair
Fair
VG
VG
VG
No
No
Yes
H
ID
Fair
No
No
Yes
H
ID
Fair
Fair-Good Fair-Good
VG
Fair
Fair
VG
VG
VG
No
No
Yes
H
ID
Fair
Good
VG
Fair
Fair
VG
VG
VG
Abbreviations: D, direct; E, excellent; EIB, exercise-induced bronchoconstriction; F, fair; FDA; US Food and Drug Administration; FEV1, forced expiratory volume in
1 second; G, good; H, high; ID, indirect; MI, minimal; NPV, negative predictive value; PPV, positive predictive value; VG, very good
MI
Direct (acts directly on tissue) vs. Indirect
(mediator release) challenge
Characteristics of Challenge
NPV for diagnosing EIB
Fair
Fair
Specificity for diagnosing EIB
Fair
Fair
Sensitivity for diagnosing EIB
Fair
VG
Fair
Good
Fair
Fair
Specificity for diagnosing asthma
Diagnosing EIB
Good
Sensitivity for diagnosing asthma
Diagnosing Asthma
Methacholine
Laboratory- Sports
bronchial
based
specific Eucapnic Hypertonic Inhaled
Inhaled
provocation Histamine exercise
exercise voluntary
saline
powdered
adenosine
challenge Challenge challenge challenge hyperpnea challenge mannitol monophosphate
Table 2. Bronchial Provocation Challenge Comparisons for Asthma and EIB
