Utilidad del cuestionario de síntomas respiratorios IUATLD para el diagnóstico diferencial del asma bronquial y la bronquitis crónica

Abstract

Our objective was to determine the diagnostic value of the questionnaire devised by the International Union against Tuberculosis and Lung Disease (IUATLD) for distinguishing between bronchial asthma and chronic bronchitis. We therefore compared clinical diagnoses established independently by two pneumologists for 211 patients to the patients' responses to the IUATLD questionnaire. The questions were analyzed for their ability to discriminate using the responses as independent variables and the diagnosis as the dependent variable. The individual predictive capacity of each question and the discriminating functions that identified the best clusters of questions were calculated using bayesian analysis. Finally, we compared IUATLD results to tests that assessed lung function (spirometry), obstruction variability (bronchodilator test, peak flow, bronchial challenge test), atopy (prick test, serum IgE), and clinical and biological markers (eosinophilia). The questionnaire correctly diagnosed 91% of the patients and a cluster of five questions registered a sensitivity of 85.6%, specificity of 91.4%, a positive predictive value of 93.1% and a negative predictive value of 82.2%, thus proving superior to the other tests. These results, along with the ease of administering the questionnaire allows us to consider the IUATLD instrument to be a good tool for the differential diagnosis of bronchial asthma and chronic bronchitis.