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Validation of the Canadian score for predicting positive specific challenges to high molecular weight agents

 Validation of the Canadian score for predicting positive specific challenges to high molecular weight agents
Five European centres using specific inhalation challenge as their method of diagnosing high molecular weight occupational asthma have validated the scoring system developed in Montreal where a score of >150 has a sensitivity of 96% and a specificity of 59% in currently exposed symptomatic workers. A free app is available @https://qxcalc.app.link/occ-asthma-hmv 

The scores are as follows 
Age =40 years [8 points] 
Presence of work-related rhinoconjunctivitis symptoms [33 points] 
Use inhaled corticosteroid [20 points] 
Exposed to flour and associated agents [61 points]
Positive sensitization to work-specific allergens [100 points] 
Positive on non-specific bronchial hyper-responsiveness test [80 points]  

The main need for those with limited or no access to specific challenge is to identify the score which has specificity high enough to remove the need for specific challenge. Adding the ROC curve to this publication would help. The app says scores 210 or greater have a sensitivity of 74%, specificity 91%, positive predicted value 90%, negative predicted value 76%

References

Full Text Available for The validity of the Canadian clinical scores for occupational asthma in European populations Suarthana E, Taghiakbari M, Saha-Chaudhuri P, Rifflart C, Suojalehto H, Hölttä P, Walusiak-Skorupa J, Wiszniewska M, Muñoz X, Romero-Mesones C, Sastre J, Rial MJ, Henneberger PK, Vandenplas O, The validity of the Canadian clinical scores for occupational asthma in European populations, Allergy, 2020;75:2124-2126,doi:10.1111/all.14294
Paul Henneberger, NIOSH, Morgantown, USA, an author of 'The validity of the Canadian clinical scores for occupational asthma in European populations' Olivier Vandenplas, Universite Mont-Goginne, Yvoir, an author of 'The validity of the Canadian clinical scores for occupational asthma in European populations' Joaquin Sastre, Fundacion Jimenez Diaz, Madrid, an author of 'The validity of the Canadian clinical scores for occupational asthma in European populations' Xavier Munoz, Barcelona, an author of 'The validity of the Canadian clinical scores for occupational asthma in European populations' Hille Suojalehto, Finnish Institute of Occupational Health, an author of 'The validity of the Canadian clinical scores for occupational asthma in European populations'

Abstract Available for Novel clinical scores for occupational asthma due to exposure to high-molecular-weight agents Taghiakbari M, Pralong JA, Lemière C, Moullec G, Saha-Chaudhuri P, Cartier A, Castano R, Suarthana E., Novel clinical scores for occupational asthma due to exposure to high-molecular-weight agents, Occup Environ Med, 2019;:,10.1136/oemed-2018-105593
André Cartier, Hôpital de Sacré Coeur, Montreal, Quebec, Canada, an author of 'Novel clinical scores for occupational asthma due to exposure to high-molecular-weight agents' Catherine Lemière, Hôpital de Sacré Coeur, Montreal, Quebec, Canada, an author of 'Novel clinical scores for occupational asthma due to exposure to high-molecular-weight agents' Jacques Pralong, Sacre Coeur, Montreal, an author of 'Novel clinical scores for occupational asthma due to exposure to high-molecular-weight agents'

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