TY - JOUR T1 - Monitoring early lung disease in cystic fibrosis: where are we now? JF - Breathe JO - Breathe SP - 34 LP - 47 DO - 10.1183/20734735.010813 VL - 10 IS - 1 AU - Julie A. Duncan AU - Paul Aurora Y1 - 2014/03/01 UR - http://breathe.ersjournals.com/content/10/1/34.abstract N2 - Educational aims To understand which techniques are available to monitor early lung disease in cystic fibrosis, recognise difficulties inherent to each measure, and describe the use of tests in clinical practice or interventional trials. Summary It is a particular challenge to detect and monitor lung disease in children younger than 6 years old. Various methods exist that can reveal abnormality in young children, but each technique presents difficulties on performing the test or interpreting results. Most children with cystic fibrosis are now diagnosed shortly after birth, but it is still unclear how to evaluate new therapies, or at what age to initiate them. This review summarises current options for monitoring early disease, limitations of individual techniques and how evidence to date influences their use in research and clinical practice. Key points Lung disease remains the major cause of morbidity and mortality in cystic fibrosis Despite clear improvements in outcomes such as nutrition, the benefit of early diagnosis by newborn screening on pulmonary health in cystic fibrosis has yet to be proven. Early lung disease is challenging to detect and monitor in young children with cystic fibrosis, but there is an urgent requirement to define useful outcome measures in this population, particularly as new treatments emerge. Many techniques are available, but difficulties with measurement or interpretation must be recognised when appraising past studies, considering their use in practice or as endpoints in clinical trials. There is no superior monitoring test at present, but emerging evidence from longitudinal studies in children with cystic fibrosis will help define which are most useful. ER -