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The difficulty in performing FEV1 in young children prompted us to assess whether PEFR could be used to measure the response to inhaled histamine. In 123 children with recurrent respiratory symptoms we found a highly significant correlation (r = 0.83, P less than 0.001) between the percentage fall from base-line of FEV1 and PEFR. We also performed histamine challenge tests using PEFR alone on 56 children too young to manage spirometry and found our procedure reliable. PEFR is an adequate measurement in histamine provocation studies and can be used interchangeably with FEV1. The criterion for a positive test is a 20% fall in either PEFR or FEV1.
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