TY - JOUR T1 - Paediatric exercise testing: Who goes the distance? JF - European Respiratory Journal JO - Eur Respir J VL - 44 IS - Suppl 58 SP - P3520 AU - Matthew Butler AU - Caroline Beardsmore AU - Erol Gaillard Y1 - 2014/09/01 UR - http://erj.ersjournals.com/content/44/Suppl_58/P3520.abstract N2 - Background: Bronchial challenge tests to demonstrate airway hyper-responsiveness (AHR) can provide valuable objective evidence of asthma where the diagnosis is in doubt. Exercise testing, an indirect measure of AHR, is often the test of choice in children. However, few studies report the clinical value and limitations of exercise testing.Aims: 1) To quantify the test outcomes of a paediatric cohort and 2) to identify patient characteristics associated with a positive result.Methods: We conducted a retrospective review of 4 years (2009-13) of exercise test data from our paediatric lung function laboratory. Patients completed a respiratory questionnaire, FeNO, serial spirometry, and a standardised 6-minute treadmill run in accordance with the ERS protocol. A fall in FEV1 of >15% from baseline was considered indicative of AHR.Results: 136 children (median age 11 years; range 5-17) underwent exercise testing. Overall, 85% finished the run but completion rate was only 58% for girls aged 12-17. Of all completers (n=116), 34 children tested positive for AHR, which was associated with worse baseline lung function, a history of atopy and FeNO >35ppb. Objective evidence supporting a diagnosis of asthma was obtained in 27% of patients with previously uncertain diagnosis.Conclusions: Exercise testing is useful in children with an equivocal asthma diagnosis. Over 40% of girls aged 12-17 did not complete the 6-min run. The reasons for the high rate of non-completion in this group are not clear. Direct challenge testing (e.g. with methacholine) may be indicated where exercise testing is either negative or not completed. Direct comparison of direct and indirect challenge testing is required to compare sensitivity and specificity of these tests. ER -