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Bronchodilator Reversibility Testing Selection Criteria and Interpretation in Allergy Office Settings
Monday, March 7, 2016
South Exhibit Hall H (Convention Center)
Rithik Binoy, Shruti Anant, Sudhir Sekhsaria, MD, Naba A. Sharif, MD
Rationale: Bronchodilator reversibility testing can be useful as a diagnostic aid for asthma. ATS guidelines for reversibility are defined as FEV1 of 12% and 200 mL above baseline values.  However, use of these criteria in allergy practices has not been studied. This study seeks to gather information about selection criteria and interpretation of bronchodilator reversibility tests in allergy practices.

Methods: An electronic survey was sent to North American allergists belonging to the American Academy of Allergy, Asthma, and Immunology (AAAAI). After a three week period, collected responses were analyzed.

Results: 496 members of the AAAAI participated in the survey. Of allergists that use bronchodilator reversibility testing, most (95.7%) administered the test to a majority of new patients with asthma symptoms (99.36%). One-fourth of allergists (25.61%) administered the test to a majority of new patients without asthma symptoms (90.38%). 374 allergists (76.64%) administered the test to a majority of new patients with a history of asthma (95.51%). Over half of allergists (55.74%) administered the test to a majority of follow-up patients with asthma (92.31%). 13.9% of allergists’ use cut-off points other ATS guidelines for interpreting positive bronchodilator reversibility tests. After a negative test, most allergists’ treat empirically, generally with inhaled corticosteroids (42.56%) or order a provocation test (27.67%).

Conclusions: Bronchodilator reversibility tests are most commonly administered for diagnosing new patients with asthma. A significant number of allergists do not follow ATS guidelines for interpreting results.  This emphasizes a need for improved education on the selection criteria and interpretation of bronchodilator reversibility tests among allergists.