Asthma Diagnosis Using Fractional Exhaled Nitric Oxide

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Diagnostic accuracy was modestly better in the corticosteroid-naive asthma patients, children, and nonsmokers than in the overall population.
Diagnostic accuracy was modestly better in the corticosteroid-naive asthma patients, children, and nonsmokers than in the overall population.

HealthDay News — Fractional exhaled nitric oxide (FeNO) measurement can diagnose asthma in individuals aged 5 years and older with moderate accuracy, according to a review published in Mayo Clinic Proceedings.

Zhen Wang, PhD, from the Mayo Clinic in Rochester, Minnesota, and colleagues conducted a systematic literature review to identify studies that evaluated FeNO diagnostic accuracy in patients ≥5 years with suspected asthma.

The researchers included 43 studies with a total of 13,747 patients. Using FeNO cutoffs of <20, 20 to 29, 30 to 39, and 40 or more parts per billion, FeNO testing yielded sensitivities of 0.8, 0.69, 0.53, and 0.41, respectively, and specificities of 0.64, 0.78, 0.85, and 0.93, respectively, in adults. 

By comparison, using FeNO cutoffs of <20 and 20 to 29 parts per billion in children yielded sensitivities of 0.78 and 0.61, respectively, and specificities of 0.79 and 0.89, respectively. In corticosteroid-naive asthma patients, children, and nonsmokers, the diagnostic accuracy was modestly better than in the overall population.

"Fractional exhaled nitric oxide measurement has moderate accuracy to diagnose asthma in individuals aged 5 years and older," the authors write.

Reference

Wang Z, Pianosi PT, Keogh KA, et al. The diagnostic accuracy of fractional exhaled nitric oxide testing in asthma: a systemic review and meta-analyses. Mayo Clin Proc. 2017 Dec 16. pii: S0025-6196(17)30831-5.

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