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J Allergy Clin Immunol Pract. 2014 May-Jun;2(3):275-80.e7. doi: 10.1016/j.jaip.2013.11.001. Epub 2014 Feb 4.

Improving screening and diagnosis of exercise-induced bronchoconstriction: a call to action.

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Department of Internal Medicine, University of Iowa, Iowa City, Iowa. Electronic address:
Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Washington, Seattle, Wash.
Division of Pulmonary, Critical Care, Allergy and Sleep Medicine, The Ohio State University Medical Center, Columbus, Ohio.
Department of Pediatrics, Division of Allergy and Clinical Immunology, Yale University, New Haven, Conn.
Allergy Asthma Colorado, P.C., Englewood, Colo.
The William Storms Allergy Clinic, Colorado Springs, Colo.
BioMedEcon, LLC, Moss Beach, Calif.


This article summarizes the findings of an expert panel of nationally recognized allergists and pulmonologists who met to discuss how to improve detection and diagnosis of exercise-induced bronchoconstriction (EIB), a transient airway narrowing that occurs during and most often after exercise in people with and without underlying asthma. EIB is both commonly underdiagnosed and overdiagnosed. EIB underdiagnosis may result in habitual avoidance of sports and physical activity, chronic deconditioning, weight gain, poor asthma control, low self-esteem, and reduced quality of life. Routine use of a reliable and valid self-administered EIB screening questionnaire by professionals best positioned to screen large numbers of people could substantially improve the detection of EIB. The authors conducted a systematic review of the literature that evaluated the accuracy of EIB screening questionnaires that might be adopted for widespread EIB screening in the general population. Results of this review indicated that no existing EIB screening questionnaire had adequate sensitivity and specificity for this purpose. The authors present a call to action to develop a new EIB screening questionnaire, and discuss the rigorous qualitative and quantitative research necessary to develop and validate such an instrument, including key methodological pitfalls that must be avoided.


Asthma; Diagnosis; Exercise-induced bronchoconstriction; Questionnaire: Accuracy; Screening; Validity

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