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Diagnostic approach...
Diagnostic approach to lower airway dysfunction in athletes: a systematic review and meta-analysis by a subgroup of the IOC consensus on 'acute respiratory illness in the athlete'
- Article/chapterEnglish2023
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LIBRIS-ID:oai:prod.swepub.kib.ki.se:151953125
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http://kipublications.ki.se/Default.aspx?queryparsed=id:151953125URI
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https://doi.org/10.1136/bjsports-2022-106059DOI
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Language:English
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Summary in:English
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Subject category:ref swepub-contenttype
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Subject category:art swepub-publicationtype
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To compare the performance of various diagnostic bronchoprovocation tests (BPT) in the assessment of lower airway dysfunction (LAD) in athletes and inform best clinical practice.DesignSystematic review with sensitivity and specificity meta-analyses.Data sourcesPubMed, EBSCOhost and Web of Science (1 January 1990–31 December 2021).Eligibility criteriaOriginal full-text studies, including athletes/physically active individuals (15–65 years) who underwent assessment for LAD by symptom-based questionnaires/history and/or direct and/or indirect BPTs.ResultsIn 26 studies containing data for quantitative meta-analyses on BPT diagnostic performance (n=2624 participants; 33% female); 22% had physician diagnosed asthma and 51% reported LAD symptoms. In athletes with symptoms of LAD, eucapnic voluntary hyperpnoea (EVH) and exercise challenge tests (ECTs) confirmed the diagnosis with a 46% sensitivity and 74% specificity, and 51% sensitivity and 84% specificity, respectively, while methacholine BPTs were 55% sensitive and 56% specific. If EVH was the reference standard, the presence of LAD symptoms was 78% sensitive and 45% specific for a positive EVH, while ECTs were 42% sensitive and 82% specific. If ECTs were the reference standard, the presence of LAD symptoms was 80% sensitive and 56% specific for a positive ECT, while EVH demonstrated 65% sensitivity and 65% specificity for a positive ECT.ConclusionIn the assessment of LAD in athletes, EVH and field-based ECTs offer similar and moderate diagnostic test performance. In contrast, methacholine BPTs have lower overall test performance.PROSPERO registration numberCRD42020170915.
Added entries (persons, corporate bodies, meetings, titles ...)
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Sewry, N
(author)
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Chenuel, B
(author)
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Backer, V
(author)
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Larsson, K
(author)
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Price, OJ
(author)
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Pedersen, L
(author)
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Bougault, V
(author)
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Schwellnus, M
(author)
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Hull, JH
(author)
Related titles
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In:British journal of sports medicine: BMJ57:8, s. 481-+1473-04800306-3674
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Reier-Nilsen, T
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Sewry, N
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Chenuel, B
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Backer, V
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Larsson, K
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Price, OJ
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Pedersen, L
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Bougault, V
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Schwellnus, M
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Hull, JH
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Karolinska Institutet