PT - JOURNAL ARTICLE AU - Zhuan Jin AU - Akihiro Shiroshita AU - Yu Tanaka AU - Kei Nakashima AU - Yuki Kataoka TI - Diagnostic accuracy and safety of inhalation challenge tests for bird fancier’s lung AID - 10.1183/13993003.congress-2020.753 DP - 2020 Sep 07 TA - European Respiratory Journal PG - 753 VI - 56 IP - suppl 64 4099 - http://erj.ersjournals.com/content/56/suppl_64/753.short 4100 - http://erj.ersjournals.com/content/56/suppl_64/753.full SO - Eur Respir J2020 Sep 07; 56 AB - Introduction: Bird fancier’s lung(BFL), a type of hypersensitivity pneumonitis, is difficult to diagnose. Inhalation challenge test(ICT) is a promising diagnostic tool; however, there is a lack of evidence of their accuracy. Moreover, adverse reactions to these tests raise safety concerns.Aims and Objectives: This study aimed to evaluate the overall sensitivity and specificity, as well as subsequent adverse reactions to ICTs performed on suspected BFL patients.Methods: We conducted a systematic review and meta-analysis of studies on suspected BFL patients who underwent ICTs. To analyze diagnostic accuracy, we searched MEDLINE, Embase, the Cochrane Library, and the International Clinical Trials Registry Platform for randomized control trials, prospective or retrospective cohort studies, and case-control studies. We included case-series and case reports to analyze adverse reactions. To evaluate the risk of bias and applicability, we used the modified Quality Assessment of Diagnostic Accuracy Studies-2 tool. We analyzed sensitivity and specificity using the hierarchical summary receiver operating characteristic(HSROC) curve, evaluated adverse reactions described in the articles.Results: We included 11 articles for analysis of diagnostic accuracy. By fixing specificity at 99% from the HSROC curve, we calculated the sensitivity as 99%. In 43 articles with descriptions of adverse reactions, 6 out of 875 patients required steroid therapy following ICTs. No patient deaths were reported.Conclusion: Our work results suggested that ICT could have high diagnostic accuracy for suspected BFL. ICT could be applied both as a rule-out and rule-in test when performed by specialists. In addition, safety concerns may be minor.FootnotesCite this article as: European Respiratory Journal 2020; 56: Suppl. 64, 753.This abstract was presented at the 2020 ERS International Congress, in session “Respiratory viruses in the "pre COVID-19" era”.This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).