Sample Peak Flow Chart – Education and debate Diurnal variability: time to change asthma guidelines? 1999; 319 doi: https://doi.org/10.1136/.319.7201.45 (released July 3, 1999) Cite this: 1999; 319: 45
Peak expiratory flow varies throughout the day in normal subjects, and this diurnal variation is increased in people with asthma. 1 Current guidelines for asthma recommend calculating diurnal variability of peak expiratory flow when diagnosing asthma. and its severity is assessed, 2
Sample Peak Flow Chart
7 also during exacerbations. 34 Diurnal peak flow variability has been used as a marker of airway responsiveness, 8 9 particularly in epidemiological studies, 10 11 and as an outcome measure in clinical asthma studies. 12 However, there are problems associated with its use.
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An alternative and simpler index of peak flow variation, such as the lowest morning peak flow expressed as a percentage of the patient’s best individual peak flow value, should be evaluated for inclusion in asthma guidelines.
Although diurnal peak flow variability has been included in asthma guidelines for many years, clinicians in primary and secondary care settings rarely use it, due to complex calculations. Several alternative equations can be used. The most common is the percentage of average amplitude (maximum – minimum) / average) or percentage of maximum amplitude (maximum – minimum) / maximum), calculated for each day and then averaged over a period of 1 to 2 weeks. 13 Determine the percentage of mean amplitude from a minimum of 7 days of twice-daily peak flow readings for the patient (see Figure 1) is …
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