TY - JOUR T1 - From the authors: JF - European Respiratory Journal JO - Eur Respir J SP - 223 LP - 224 DO - 10.1183/09031936.00143910 VL - 37 IS - 1 AU - S. Aaron AU - V. Luks Y1 - 2011/01/01 UR - http://erj.ersjournals.com/content/37/1/223.abstract N2 - From the authors:A. D'Urzo has correctly identified from our data 1 that bronchial challenge testing seems to be a more sensitive test to confirm asthma compared to pre- and post-bronchodilator spirometry. Our results were similar to those of Goldstein et al. 2 who demonstrated that bronchial challenge testing with methacholine has far greater sensitivity to diagnose asthma compared with post-bronchodilator spirometry. Despite these findings, pre- and post-bronchodilator spirometry should probably be the first-line test to diagnose or confirm asthma for several reasons. Inducing bronchoconstriction with a bronchial challenge test poses a risk to the patient that could be avoided if that patient is able to have asthma diagnosed, or confirmed, with post-bronchodilator spirometry. Admittedly, the risk may be more theoretical than evidence-based. For example, to date there are no reported deaths from methacholine challenge testing 3 and there are studies demonstrating that it is … ER -