A literature review of the evidence that a 12% improvement in FEV₁ is an appropriate cut-off for children

Introduction: A well-performed spirometry, using a change in forced expiratory volume in one second (FEV₁) after albuterol, is commonly used to support the likelihood of an asthma diagnosis. The current standard, accepted by the 2007 National Heart Lung and Blood Institute Asthma Expert Panel Report-3 (EPR-3) guidelines, is a 12% improvement in the FEV₁ after a bronchodilator. Objective: We sought to determine whether existing studies support or refute using a 12% improvement as a significant change in FEV₁ in children and adolescents. Data sources: We reviewed the literature of children and adolescents using Medline searches to discover pertinent population studies and comparative studies that included FEV₁ measurements. Result: The majority of the discovered studies suggest a leb stringent improvement in FEV₁ in children might be applicable. Conclusion: Supported by the published literature, we suggest an alternative interpretive strategy of exprebing the results of a spirometry measurement when a diagnosis of asthma in a child is being considered using a bronchodilator response.