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Asthma and Lung Function Tests

An information paper for health professionals

Spirometry
Practical tips - spirometry
Peak Expiratory Flow
Levels of evidence
References
Content created MAR 2005
Content updated MAR 2005

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NextBackLevels of evidence

I           Evidence obtained from a systematic review of all relevant randomised controlled trials
II Evidence obtained from at least one properly designed randomised controlled trial
III-1 Evidence obtained from well-designed pseudo-randomised controlled trials (alternate allocation or some other method)
III-2 Evidence obtained from comparative studies with concurrent controls and allocation not randomised (cohort studies), case-control studies, or interrupted time series with a control group
III-3 Evidence obtained from comparative studies with historical control, two or more single-arm studies, or interrupted time series without a parallel control group
IV Evidence obtained from case series, either post-test or pre-test and post-test  

These levels of evidence ratings have been adapted from US Preventive Services Task Force (1989) Guide to clinical preventive services: an assessment of the effectiveness of 169 interventions (ed M Fisher), Williams and Williams, Baltimore, Appendix A, p 388.

Source: NHMRC
A guide to the development, implementation and evaluation of clinical practice guidelines.

References

1

Pierce R and Johns DP. Spirometry: The Measurement and Interpretation of Ventilatory Function in Clinical Practice. National Asthma Campaign, Melbourne, 1995.

2

Asthma Management Handbook, National Asthma Council, Melbourne, 2002;4.

3 Asthma Management Handbook, National Asthma Council, Melbourne, 2002;5.
4 Miller MR, Dickinson SA, Hitchings DJ. The accuracy of portable peak flow meters. Thorax 1992; 47: 904-9.
5 Sawyer G, Miles J, Lewis S, Fitzharris P, Pearce N, Beasley R. Classification of asthma severity: should the international guidelines be changed. Clin Exp Allergy 1998; 28: 1565-1570.
6 Emerman, C and Cydulka, R. 1995. Effect of pulmonary function testing of acute asthma. Archives of Internal Medicine 155(20):2225-28.
7 Rubinfeld, AR and Pain, MC. 1976. Perception of asthma. Lancet 1(7965):882-4.
8 Newman SP, Millar AB, Lennard-Jones TR, Moren F, Clarke SW. Improvement of pressurised aerosol deposition with Nebuhaler spacer device. Thorax 1984; 39: 935-41.
9

Silkstone VL, Corlett SA, Chrystyn H. Relative lung and total systemic bioavailability following inhalation from a metered dose inhaler compared with a metered dose inhaler attached to a large volume plastic spacer and a jet nebuliser. Eur. J Clin Pharmacol 2002; 57: 781-6.

10 Gibson PG, Coughlan J, Wilson AJ, Abramson M, Bauman A, Hensley MJ, Walters EH. Self-management education and regular practitioner review for adults with asthma (Cochrane Review). The Cochrane Library, Issue 2 2002. Oxford: Update Software.
11 Shingo S, Zhang J, et al. (2001). Correlation of airway obstruction and patient-reported endpoints in clinical studies. Eur Respir J 17(2): 220-4.
12 Verini M, Rossi N, et al. (2001). Lack of correlation between clinical patterns of asthma and airway obstruction. Allergy Asthma Proc 22(5): 297-302.
13 Fardy HJ. Spirometry: Value adding in GP asthma care. GP Review 2001;5:9:21.
14 Teeter JG, Bleecker ER, (1998). Relationship between airway obstruction and respiratory symptoms in adult asthmatics. Chest 113(2): 272-7.
15 Crockett AJ, Grimmond T. Guidelines for Infection Control in a Respiratory Function Laboratory. Thoracic Society News 1993; 6-7.
16 Thiadens HA, De Bock GH, et al. (1999). Can peak expiratory flow measurements reliably identify the presence of airway obstruction and bronchodilator response as assessed by FEV(1) in primary care patients presenting with a persistent cough? Thorax 54(12): 1055-60.
17 Asthma Management Handbook, National Asthma Council, Melbourne, 2002;6.
18 Gautrin DL, D’Aquino C, et al. (1994). Comparison between peak expiratory flow rates (PEFR) and FEV1 in the monitoring of asthmatic subjects at an outpatient clinic. Chest 106(5): 1419-26.
19 Reddel HK, Toelle BG, et al. (2002). Analysis of adherence to peak flow monitoring when recording of data is electronic. BMJ 324(7330): 146-7.

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