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Repeatability of the low‐dose ACTH test in asthmatic children on inhaled corticosteroids
Author(s) -
Gupta Atul,
Cheetham Tim,
Jaffray Clare,
Ullman Denise,
Gibb Ian,
Spencer David A
Publication year - 2009
Publication title -
acta pædiatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/j.1651-2227.2009.01479.x
Subject(s) - medicine , repeatability , fluticasone propionate , asthma , inhaled corticosteroids , kappa , fluticasone , statistic , pediatrics , statistics , mathematics , geometry
Aim: To assess the repeatability of low‐dose Synacthen test (LDST) in asthmatic children receiving high‐dose fluticasone propionate (FP). Methods: Low‐dose Synacthen test was performed on 18 children with stable chronic asthma treated with FP at a constant daily dose of ≥500 μg and repeated 1 month later. Repeatability was assessed using the Kappa statistic for categorical variables. Results: Fifteen patients had consistent results (either two normal or two abnormal responses) and three patients had inconsistent results (one normal and one abnormal response). The Kappa statistic was 0.56 indicating fair to good agreement between the tests. Conclusion: The results of adrenal function testing in patients on inhaled steroids can have major implications for patient management, making it important to use a test with excellent repeatability. The LDST conducted using our protocol does not fulfil this criterion.