Spirometry Measurement in Childhood Asthma

Topic Suggestion

1. What is the decision or change you are facing or struggling with where a summary of the evidence would be helpful?

I am interested in the aspect of spirometry measurement in children that have demonstrated a history of respiratory episodes, such as asthma exacerbations. It would be good to have a review of advantages and limitations.

2. Why are you struggling with this issue?

I have conducted research in childhood asthma for almost 40 years including some studies that have long-term measurement of spirometry in children beginning at age 5 to 12 years. This was part fo the NHLBI Childhood Asthma management Program. We observed at least four patterns of lung development in children as report in the NEJM by MccGeachie at al several years ago. It is becoming more apparent that asthma should be followed as a life course disease and yet spirometry has not become part fo routine measurement in a way that blood pressure is monitored as part of hypertension follow-up.

3. What do you want to see changed? How will you know that your issue is improving or has been addressed?

There are a number of studies now that support he aspect of asthma as a progressive disease in children with childhood asthma. Yet, we have not adapted a life course approach to monitoring asthma that could emerge to physiologic equivalents of advanced COPD. It is time to move int hat direction especially in consideration of the continuous exposure to smoking, vaping and the environment.

4. When do you need the evidence report?

Fri, 01/15/2021

5. What will you do with the evidence report?

A systematic report could help prompt clinicians to advocate for the application of spirometry as a required measure for children with asthma or frequent episodes of respiratory symptoms. It is something that should become part of asthma guidelines.

Supporting Document

Patterns of Growth and Decline in Lung Function in Persistent Childhood Asthma (PDF, 668 KB)

Title or short description:

Lung Function in Persistent Childhood Asthma

Comments or notes about this file: Thi sis an important study regarding serial measurements of pulmonary function in children with mild to moderate asthma. One should also look at the appendix to see the various patterns that emerged overtime.
 

(Optional) About You

What is your role or perspective?

Physician/pediatrician/asthma research

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May we contact you if we have questions about your nomination?

Yes

Title: Director, Pediatric Asthma Research, The Breathing Institute, Children's Hospital Colorado