Bright P, Newton DT, Gannon PF et al, Improved Analysis Of Serial Peak Expiratory Flow In Suspected Occupational Asthma, Monaldi Arch Chest Dis, 2001;56:281-288,

BOHRF Original Authors' Main Conclusions

The original authors' main conclusions are taken from Abstract, Results and Discussion. They are decided upon by the authors of the BOHRF occupational asthma guidelines and form part of the guidelines.

268 serial peak expiratory flow (PEF) records made by workers with possible occupational asthma were divided into 4 sets. The first 2 were development sets and sets 3 and 4 were "gold standard" sets where the diagnosis had been made independently. Set 3 was used to set cut-off for occupational effect, the sensitivity and specificity for the combined model was determined from the fourth set. The fourth set was also used to determine the sensitivity and specificity of the human expert. The repeatability of the human expert re-scoring the same complexes had a weighted kappa score of 0.71. OASYS-3 was 100% repeatable. Both OASYS-3 and OASYS-2 tended to score records less positively for work-related changes in PEF than the expert. The sensitivity of OASYS-3 was better than OASYS-2 (82% and 75% respectively) for an equivalent specificity (94%). The sensitivity of the human expert was 100% with a specificity of 93%. OASYS-3 provides an objective method of interpreting serial PEF records with sensitivity and specificity approaching that of a human expert.

BOHRF Associated Evidence Statements

The BOHRF occupational asthma guidelines state that this reference is associated with the following evidence statements

** 3 The sensitivity and specificity of serial peak flow measurements are high in the diagnosis of occupational asthma

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