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Disclaimer
is Guideline attempts to define principles of practice that should produce high-quality patient care.
It is applicable to specialists, primary care, and providers at all levels. is Guideline should not be
considered exclusive of other methods of care reasonably directed at obtaining the same results. e
ultimate judgment concerning the propriety of any course of conduct must be made by the clinician
aer consideration of each individual patient situation.
Neither IGC, the medical associations, nor the authors endorse any product or service associated with
the distributor of this clinical reference tool.
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Source
Weiler JM, Brannan JD, Randolph CC, Hallstrand TS, Parsons J, Silvers W, Storms W, Zeiger
J, Bernstein DI, Blessing-Moore J, Greenhawt M, Khan D, Lang D, Nicklas RA, Oppenheimer
J, Portnoy JM, Schuller DE, Tilles SA, Wallace D. Exercise-induced bronchoconstriction
update-2016. J Allerg y Clin Immunol. 2016;138:1292-1295.
Abbreviations
AHR, airway hyperresponsiveness; β
2
, beta agonist; D
LCO
, diffusing capacity of the lung for
carbon monoxide; EKG, electrocardiograph; EVH, eucapnic voluntary hyperpnea; FEV
1
,
forced expiratory volume in 1 sec; GERD, gastro-esophageal reflux disease; ICS, inhaled
corticosteroids; LABA, long acting β
2
agonist; SABA, short acting β
2
agonist; SS, summary
statement; VCD, vocal cord dysfunction
Strength of Recommendation and Quality of Evidence
Strength of Recommendation Quality of Evidence
S Strong: Benefit clearly
exceeds harm
A / B Directly based on category I–II evidence
M Moderate: Benefit
exceeds harm but
quality of evidence is
not as strong
B / C Directly based on category II–III evidence or
extrapolated recommendation from category I
evidence
W Weak: Quality of
evidence is suspect
or there is little clear
advantage to one
approach vs. another
D Directly based on category IV evidence or
extrapolated recommendation from category I, II,
or III evidence