[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-455506-105":3,"detail-sidebar-cat-0-en-105":81,"doc-detail-455506-en":131},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":74,"head_meta":76,"extra_data":78,"updated_unix":80},105,"en","assessing-diagnostic-accuracy-for-asthma-with-home-spirometry-in-primary-care","Assessing diagnostic accuracy for asthma with home spirometry in primary care","","Evaluate diagnostic accuracy of lung function measurements for asthma in Swedish primary care, including trial inhaled corticosteroid treatment when diagnosis remained unclear. Undiagnosed patients with asthma-like symptoms received remote or in-clinic spirometry with bronchodilator responsiveness testing (BDR) and home spirometry over 2–4 weeks for diurnal variability of FEV1 and PEF. Of 123 participants, 71 were diagnosed with asthma. BDR showed high specificity for documented diagnosis, while home diurnal variability testing provided the strongest overall balance between sensitivity and specificity.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/assessing-diagnostic-accuracy-for-asthma-with-home-spirometry-in-primary-care/455506/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/assessing-diagnostic-accuracy-for-asthma-with-home-spirometry-in-primary-care/455506.png","ImageObject",300,407,{"name":42,"@type":43},"Emma 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had very high specificity (100%) but low sensitivity, while diurnal variability testing via home spirometry offered the strongest overall balance between sensitivity and specificity for asthma.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},455506,1790794910,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,110,115,120,123,127],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & 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for asthma with homespirometry in primary care  \nLynnea Myers1 ✉, Martin Bellander2, Henrik Ljungberg1,3, Martine Isachsen1, Marianne Eduards4, Marie Lindman5, Anna Carleborg 1, Maria Rosengren4, Magnus Jansson6, Hanna Sandelowsky4,7, Kjell Larsson8 and Björn Nordlund1,3  \n\n| | The aim was to evaluate the diagnostic accuracy of lung function measurements for asthma in primary care, including trial treatment. Undiagnosed patients seeking care for asthma-like symptoms were assessed at primary healthcare centers in Sweden. Participants underwent remote or in-clinic spirometry with bronchodilator responsiveness testing (BDR), remote diurnal variability testing of forced expiratory volume in 1 s (FEV1) and peak expiratory flow (PEF) over 2–4 weeks using a home spirometry system; and if necessary, three-months trial treatment with inhaled corticosteroids. Overall, 71/123 (58%) were diagnosed with asthma. When comparing patients by asthma diagnosis, sensitivity and specificity for documented diagnosis were 9%(95% CI 3–17) and 100%(93–100) for BDR; 61%(48–72) and 58%(43–71) for FEV ; and 76%(64–85) and 69%(55–81) for PEF Diurnal variability testing | |\n| --- | --- | --- |\n|  |  |  |\n|  |  |  |\n|  |  |  |\n|  |  |  |\n|  |  |  |\n|  |  |  |\n|  | via home spirometry showed the strongest balance among sensitivity and specificity for asthma. |  |\n|  | npj Primary Care Respiratory Medicine (2026)36:3; [https://doi.org/10.1038/s41533-025-00471-5](https://doi.org/10.1038/s41533-025-00471-5) |  |\n|  |  |  |\n\n₁  \n.  \nINTRODUCTION  \nThe global prevalence of asthma-like symptoms ranges from 1–33% in adults1 and approximately 10% in children2. Symptoms of asthma are recognised as cough, wheeze, shortness of breath, and chest tightness, which are more pronounced at night, in the morning, or during exertion. The Global Initiative for Asthma (GINA) 2024 defines asthma as a heterogeneous disease with chronic airway inflammation, variable respiratory symptoms, and fluctuating airflow limitations3.  \nAsthma is frequently under-diagnosed and under-treated in low- and middle-income countries4, while there is evidence of over-diagnosis and over-treatment in high-income countries5. There is a strong recommendation that the diagnosis is not based on symptoms alone3,6,7. Spirometry is a recommended diagnostic test per GINA guidelines3, typically through bronchodilator responsiveness testing (BDR) or by positive diurnal peak expiratory flow (PEF) variability. A European Respiratory Society task force has concluded that due to variable airway obstruction in asthma, BDR alone has a low sensitivity, but high specificity for asthma diagnosis8. Meanwhile, PEF variability testing is often underutilized in healthcare as it is considered time-consuming, challenging to manage, and lacks evidence8–10. The task force also notes that forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) ratio correlate more closely with airway obstruction than PEF, for example8. GINA guidelines only currently recommend PEF measurements for variability3; however, a few studies have evaluated the potential value of FEV1 variability for diagnosis and the correlation between diurnal FEV1 and PEF variability11–13. With these clinical challenges and opportunities, it is advised to verify variable expiratory airflow limitation before treating asthma3, 14.  \nAsthma diagnosis remains a global clinical challenge. There is currently no “gold standard” for asthma diagnosis in primary care  \nsettings. However, the goal of diagnosis is to determine the probability of asthma based on a combination of factors such as symptom assessment, objective lung function investigations, and patient response to treatment. Additionally, individuals with asthma experience fluctuating phases of symptoms, along with remission or relapse, which can lead to normal spirometry results in clinical settings15 and underd","cbCaimLpYbBFJMqT","https://ap.wps.com/l/cbCaimLpYbBFJMqT","pdf",776261,"English","# Introduction\n## Rationale for objective testing\n## Home spirometry and prior evidence\n## Study aims and STARD reporting","[{\"question\":\"What was the main aim of the study?\",\"answer\":\"To evaluate the diagnostic accuracy of lung function measurements for asthma in primary care, including treatment trials when diagnosis was unclear.\"},{\"question\":\"How were participants assessed for asthma?\",\"answer\":\"Participants underwent spirometry with bronchodilator responsiveness testing (BDR) either remotely or in clinic, and completed home spirometry over 2–4 weeks for diurnal variability of FEV1 and PEF.\"},{\"question\":\"What were the key findings on diagnostic performance?\",\"answer\":\"BDR had very high specificity (100%) but low sensitivity, while diurnal variability testing via home spirometry offered the strongest overall balance between sensitivity and specificity for asthma.\"}]","Assessing diagnostic accuracy for asthma with home spirometry in primary care | PDF",1790743267,23]