Assessing mass spectrometry breath test methods for asthma diagnosis in wheezing preschool children

More than 40% of children under 6 experience wheezing. It remains a challenge for healthcare professionals to distinguish preschool children with transient wheeze from those at high risk of asthma. An early asthma diagnosis could improve healthcare. In this regard, the ADEM study has already shown the potential of Gas Chromatography – Time of Flight – Mass Spectrometry (GC-ToF-MS) for breath analysis to diagnose asthma based on an algorithm published by Klaassens et al in 2015. However, its feasibility is hampered by high costs, time and expertise demands. The present work (which is part of the ADEM2 RCT and cohort study) aims at assessing whether Selected Ion Flow Tube – Mass Spectrometry (SIFT-MS) could offer comparable diagnostic outcomes in preschool wheezers compared to GC-ToF-MS. The MosaKids Children's Hospital in Maastricht carried out breath sample analyses using both methods to assign a diagnostic probability of having asthma or not. Initially, a significant positive correlation (p<0.001) was found between the probability scores derived from each analysis method. Subsequently, a McNemar's test for changes was conducted on the binary diagnostic outcomes, with a probability threshold set at 0.5. This test, applied to 174 samples, revealed no significant differences in the diagnostic capabilities of the two methods (p>0.05). The results suggest a reasonable comparability between SIFT-MS and GC-ToF-MS. Future analysis to determine each method's sensitivity and specificity compared to the available gold standard for asthma detection is planned once definitive diagnoses will possible at the age of 6 (according to the current ERS criteria).