{
  "abstract": "Aim To assess and review one financial year (2022-2023) of mannitol challenge appointments and compare presenting symptoms with clinical outcomes. To assess service burden and compare anecdotally low positive rate to literature.Introduction Mannitol challenge testing supports the diagnosis of airway hyper-responsiveness in suspected asthma.With high demand on service capacity (mean waiting time 41 days SD14) and low anecdotal positive rate review of testing useful to assess diagnostic impact of testing for service review.Methods Retrospective review of mannitol challenges during FY 2022–2023 (figure 1)Booking system queried for appointment status and completionClinic letters reviewed for symptoms and final diagnosesDescriptive analysis; Fisher’s exact test usedResults 141 tests for 118 patients73 tests completed (51.8%)8 positive mannitol outcomes:– 5.6% of all appointments– 10.9% of completed testsSymptoms and Outcomes SOBOE: 32 negative / 6 positive (P value 0.705)Cough: 15 negative / 1 positive ( P value 0.252)Wheeze: 16 negative / 1 positive (P value 1.000)Other / mixed: 8 negative / 0 positive (P value 1.000)Total: 71 negative / 8 positiveDiscussion Mannitol positivity was lower than reported specialist cohorts (40%-70%(1)) but comparable to mixed-probability populations (11.1% (2)).SOBOE showed a higher proportion of positive outcomes, though not statistically significant.A higher proportion of patients were still diagnosed with or suspected to have asthma.Diagnosis breakdown -Asthma suspected - 13.9%Asthma confirmed - 15.2%Reflux and ENT - 20.3%No Active respiratory disease 30.3%cough hypersensitivity - 2.5%COPD - 2.5%Cardiac related 2.5%Dysfunctional breathing - 3.8%Mixed unclear - 19%Conclusions Mannitol challenge demonstrated low diagnostic yield.High non-completion rates contributed to service burden.Refined referral pathways may improve efficiency and patient selectionFuture directions for service reviewReview of referral triage to confirm completing of previous test – almost as many positive from new obstruction as positive mannitol challengeConsider options for patient booking with significant number of DNA (23) and patient cancelled on day (22).Abstract P62 Figure 1",
  "authors": [
    {
      "affiliations": [
        "Leeds Teaching Hospitals Trust, Leeds, United Kingdom"
      ],
      "name": "Daniel Grant"
    }
  ],
  "title": "P62 A (mannitol) challenging conversation",
  "uid": "546981c7-15b8-5d55-b249-981a40471e5e"
}