ArticleAnnals of family medicine
Diagnostic value of oral prednisolone test for chronic obstructive pulmonary disorders.
Article in Annals of family medicine. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
4 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Use of expert panels to define the reference standard in diagnostic research: a systematic review of published methods and reporting.PLoS medicine · 2013Pooled it
- Diagnostic value of a 3-day course of prednisolone in patients with possible rheumatoid arthritis - the TryCort study.Arthritis research & therapy · 2017Trial
- Diagnosis and pharmacotherapy of stable chronic obstructive pulmonary disease: the finnish guidelines.Basic & clinical pharmacology & toxicology · 2015Review
- In this issue: Back to basics: talking, listening, and low-tech primary care.Annals of family medicineArticle
Corrections and comments
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeWe wanted to determine the diagnostic value of an oral prednisolone test for chronic obstructive pulmonary disorders.
methodsTwo hundred thirty-three patients with cough for longer than 14 days, without known chronic obstructive pulmonary disease (COPD) or asthma, participated in a diagnostic study in Dutch primary care between 2006 and 2009. These patients used a 14-day prednisolone test of 30 mg/d and recorded before-after bronchodilator measurements of forced expiratory volume in 1 second (FEV(1)). An expert panel determined the presence or absence of COPD and asthma based on an extensive diagnostic workup. The proportion of responders to the prednisolone test (increased FEV(1) exceeding 200 mL or 12% of baseline) per diagnosis group was compared, and the diagnostic value of the test was quantified by logistic regression and analysis of the area under the receiver operating characteristic curve (ROC area).
resultsIn patients with COPD, 23% (14 of 61) responded to the test; in patients with asthma 4% (1 of 25) responded; in patients with asthma and COPD, 7% (1 of 14) responded; and in those without asthma or COPD, 11% (14 of 133) responded. Being a responder was, unexpectedly, associated with COPD (OR = 2.4; 95% confidence interval [CI], 1.1-5.2). After multivariate analysis, adjusting for age, sex, and smoking, the OR = 2.0 (95% CI, 0.8-5.0) and the ROC area did not increase (0.78; 95% CI, 0.72-0.85 vs 0.79; 95% CI, 0.72-0.85).
conclusionA response to a prednisolone test was suggestive of COPD, but added no diagnostic value to more easily obtainable characteristics.
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