RT Journal Article SR Electronic T1 Sensitivity and specificity of the histamine challenge test for the diagnosis of asthma in an unselected sample of children and adolescents JF European Respiratory Journal JO Eur Respir J FD European Respiratory Society SP 1093 OP 1100 DO 10.1183/09031936.93.04091093 VO 4 IS 9 A1 V Backer A1 S Groth A1 A Dirksen A1 N Bach-Mortensen A1 KK Hansen A1 EM Laursen A1 D Wendelboe YR 1991 UL http://erj.ersjournals.com/content/4/9/1093.abstract AB The purpose of this investigation was to study factors of importance for the degree of bronchial responsiveness and, furthermore, to evaluate the sensitivity, specificity and predictive value of a bronchial challenge test with histamine for the diagnosis of asthma in 495 randomly selected children and adolescents, aged 7-16 yrs, from Copenhagen, Rigshospitalet. Detailed history about allergic symptoms, physical examination and bronchial histamine challenge tests were performed at the out-patient clinic. Asthma, atopic disease and height were found to be of great importance for the degree of bronchial responsiveness, whereas the age, sex and smoking habits were of no significance. The percentage of asthmatics with bronchial hyperresponsiveness, i.e. sensitivity to the test, increased towards 100% on inhaling increasing concentrations of histamine, but this was accompanied by a decrease in specificity and predictive values of positive test in regard to the diagnosis of asthma. However, lower concentrations of histamine may be preferable in order to distinguish between asthma and non-asthma in population samples, as inhalation of 2.4 mg.ml-1 and provocative concentration producing a 20% fall in forced expiratory volume in one second (FEV1) (PC20) provided an acceptable sensitivity (57%), specificity (98%), and predictive value of a positive test (60%). We conclude that as regards the diagnosis of asthma, a low predictive value confirms that the bronchial challenge test plays only a supplementary, but valuable, role in detecting the disease in population samples.