[Chinese expert consensus on the clinical applications of bronchial provocation test (2024 edition)].

The bronchial provocation test (BPT) is an important clinical examination to detect airway hyperresponsiveness, primarily in diagnosing asthma with FEV1≥70% of predicted value, including typical asthma and atypical asthma such as cough variant asthma and chest tightness variant asthma. BPT is a valuable tool in differentiating asthma from other chronic airway diseases and assessing the efficacy of asthma treatment. Despite its clinical significance, BPT remains largely underused in clinical practice, primarily due to limited knowledge of its importance and inadequate availability of medical professionals, equipment and medications in primary care settings. In response to this gap, the China Asthma Group of Chinese Thoracic Society has drafted this expert consensus to enhance knowledge and application of BPT among clinical practitioners. This expert consensus specifically focuses on the classic direct provocation agent methacholine, covering general principles and classification of BPT; indications, contraindications, and clinical applications; result interpretation; analyzing potential reasons and coping strategies for false positive and false negative test results; and finally, providing safety precautions and emergency measures. The aim of this expert consensus is to promote the standardized application of BPT.