Background A valid bronchoscopic scoring tool for bronchitis would be useful for clinical and research purposes as currently there are none in children. From 100 digitally recorded flexible bronchoscopies (FB), we related the various macroscopic features to airway neutrophil % to develop a FB‐derived bronchitis score (BScoreexp). We aimed to develop a FB‐derived bronchitis tool. Methods FB recordings for six visualised features: secretions (amount and color) and mucosal appearance (erythema, pallor, ridging, oedema) based on pre‐determined criteria on a pictorial chart were assessed by two physicians independently, blinded to the clinical history. These features were used to obtain various models of BScoreexp that were plotted against bronchoalveolar lavage (BAL) neutrophil % using a receiver operating characteristic (ROC) curve. Inter‐ and intra‐rater agreement (weighted‐kappa, K) were assessed from 30 FBs. Results Using BAL neutrophilia of 20% to define inflammation, the highest area under ROC (aROC) of 0.71, 95%CI 0.61‐0.82 was obtained by the giving three times weightage to secretion amount and color and adding it to erythema and oedema. Inter‐rater K values for secretion amount (K = 0.87, 95%CI 0.73‐1.0) and color (K = 0.86, 95%CI 0.69‐1.0) were excellent. Respective intra‐rater K were 0.95 (0.87‐1.0) and 0.68 (0.47‐0.89). Other inter‐rater K ranged from 0.4 (erythema) to 0.64 (pallor). Conclusion A repeatable FB‐defined bronchitis scoring tool can be derived. However, a prospective study needs to be performed with larger numbers to further evaluate and validate these results.

Background and objective Ethnic‐specific reference equations are recommended when performing spirometry. In the absence of appropriate reference equations for Australian Aboriginal and/or Torres Strait Islanders (Indigenous), we determined whether any of the existing Global Lung Function Initiative (GLI)‐2012 equations were suitable for use in Indigenous children/young adults. Methods We performed spirometry on 1278 participants (3–25 years) who were identified as Aboriginal, Torres Strait Islander or ‘both’. Questionnaires and medical records were used to identify ‘healthy’ participants. GLI2012_DataConversion software was used to apply the ‘Caucasian’, ‘African‐American’ and ‘other/mixed’ equations. Results We included 930 healthy participants. Mean z‐scores for forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) were lower than the Caucasian predicted values (range: −0.53 to −0.60) and higher than African‐American (range: 0.70 to 0.78) but similar to other/mixed (range: 0.00 to 0.08). The distribution of healthy participants around the upper and lower limits of normal (~5%) fit well for the other/mixed equation compared to the Caucasian and African‐American equations. Conclusion Of the available GLI‐2012 reference equations, the other/mixed reference equation provides the best overall fit for Indigenous Australian children and young adults (3–25 years). Healthy data from additional communities and adults around Australia will be required to confirm generalizability of findings.