(Engelberg, 1988). Finally, estimates of disease incidence or prevalence often result from epidemiological studies in which pulmonary function tests are used to ascertain disease.

Recommendation: Include pulmonary function tests in epidemiological studies to help improve estimates of disease incidence and prevalence. Because they are portable and can be self-administered, tests that utilize peak-flow measurements are most desirable for this purpose.

One drawback of many pulmonary function tests is that they must be administered by technicians. Peak flow measurements are less reliable but are highly portable, can be self-administered, and are therefore often more sensitive in the diagnosis of asthma.

Recommendation: Include objective measures of respiratory function in experimental protocols designed to determine the efficacy of therapeutic strategies (e.g., pharmacotherapy, environmental modification, avoidance) used to treat respiratory diseases caused by indoor allergens.

Bronchial hyperreactivity is a feature of asthma that correlates with clinical severity and does not require repeated measurement (Boushey et al., 1980). It is unclear, however, whether bronchial hyperreactivity can be correlated with exposure to indoor allergens.

Research Agenda Item: Determine whether changes in bronchial hyperreactivity can be correlated with exposure to indoor allergens. If such a correlation exists, determine how reducing the level of allergens affects bronchial hyperreactivity.