Asthma Clinical Trial
To determine whether there is a difference in two different breathing tests used to detect asthma. Hypothesis: The Digidoser delivers less methacholine to the airways and will result in a higher PC20 than the value determined by the Rosenthal Dosimeter.
Bronchoprovocation with methacholine is used to confirm the diagnosis of asthma. The
procedure involves inhaling methacholine through a nebulizer attached to a dosimeter that
delivers a precise volume of methacholine. The endpoint of the test is the provocational
concentration that produces a 20% decrease in FEV1 (PC20). To standardize the procedure, the
American Thoracic Society (ATS) recommends that the nebulizer output be calibrated to
deliver an output of 0.9 ± 0.09 mL/min.
The Rosenthal Dosimeter and the KoKo Digidoser are two commonly used dosimeters. In an
attempt to follow the ATS guideline we discovered that the nebulizer output was lower with
the KoKo Digidoser and could not be calibrated. However, it is unclear whether the apparent
lower output is a result of the Digidoser delivering less solution or that the ATS method of
determining output is not applicable to this dosimeter. To answer this question, we propose
to determine the methacholine PC20 in subjects with asthma using the two dosimeters. It is
our hypothesis that the Digidoser delivers less methacholine and thus will produce a higher
PC20 than the Rosenthal Dosimeter.
Twelve nonsmoking subjects with mild asthma will be selected on the basis of > 18 years of
age, a baseline FEV1 of > 60% predicted and a screening PC20 of < 8mg/ml. Subjects will be
randomized to perform a methacholine challenge with the Digidoser and the Rosenthal
Dosimeter on two different days in an unblinded, crossover manner. The geometric mean PC20
with each dosimeter will be compared with a paired t test. The results of this study will
indicate whether the Digidoser has the potential of causing false negative test results or
whether the ATS method of determining output should not be used with this dosimeter.
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Allocation: Randomized, Intervention Model: Crossover Assignment, Masking: Open Label, Primary Purpose: Diagnostic
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