RT Journal Article SR Electronic T1 Routine FEV1 measurement is essential in diagnosis and monitoring of childhood asthma: myth or maxim? JF Breathe JO Breathe FD European Respiratory Society SP 230048 DO 10.1183/20734735.0048-2023 VO 19 IS 2 A1 Onisor, Maria Octavia A1 Turner, Steve YR 2023 UL http://breathe.ersjournals.com/content/19/2/230048.abstract AB Childhood asthma is a common condition in children. This review describes the evidence from seven asthma guidelines for using spirometry in the diagnosis and monitoring of childhood asthma. All guidelines recommend spirometry as the primary test to be performed for diagnosing asthma in children aged >5 years. Spirometry is often normal in children with asthma. Guidelines are not consistent with respect to whether forced expiratory volume in 1 s (FEV1) or FEV1/forced vital capacity (FVC) should be measured, or their threshold for “abnormal” spirometry, and we describe the sensitivity and specificity for these different cut-offs. The role of spirometry in monitoring asthma is less clear in the guidelines, and some do not suggest spirometry should be done. There is no consensus on what spirometric measurement should be used, how often it should be measured and what is a minimum clinically important change in spirometry. The role of spirometry in diagnosing asthma is more clearly established when compared to its role in monitoring asthma. The potential of spirometry to aid decision making for asthma diagnosis and monitoring in children remains to be fully evaluated.Educational aimsTo provide knowledge of the commonly used guidelines for asthma diagnosis and management.To give insight into the opportunities and challenges in using spirometry to diagnose and monitor asthma in children.To provide an understanding of the precision of spirometry for diagnosing asthma.All guidelines recommend spirometry as the initial test to be carried out in support of a clinical diagnosis of asthma in children aged over 5 years. There is no consensus on the role of spirometry in monitoring childhood asthma. https://bit.ly/3JgbRGu