FeNO test might be useful tool that helps with bronchial asthma diagnosis

A meta-analysis printed in Mayo Clinic Proceedings implies that fractional exhaled nitrous oxide (FeNO) is a great evidence-based adjunct test for bronchial asthma

Although about 24 million Americans are identified as having bronchial asthma each year, there’s not one test that may identify the condition. Common signs and symptoms, for example difficulty breathing, wheezing, and cough, are relatively nonspecific, and physicians could use multiple tests and observations to achieve a precise diagnosis. To be able to measure the precision and longevity of one of these simple tests that may be put into the clinician’s toolbox to identify bronchial asthma – fractional exhaled nitric oxide supplement (FeNO) concentration – researchers collected and examined data from previous peer-reviewed studies. They conclude the FeNO test has moderate precision for patients aged 5 and older. Their answers are reported in Mayo Clinic Proceedings.

Researchers in the AHRQ-funded Evidence-based Practice Center at Mayo Clinic (Rochester, MN) identified 43 studies comprising as many as almost 14,000 adult and pediatric patients with suspected bronchial asthma who received the FeNO test. This review was commissioned by AHRQ and also the National Institutes of Health, National Heart, Lung, and Bloodstream Institute, area of the U.S. Department of Health insurance and Human Services.

“Bronchial asthma can often be hard to identify, and FeNO could be useful to create therapeutic decisions more evidence based,” described lead investigator M. Hassan Murad, MD, Miles per hour, from the Mayo Clinic. “Additionally to some patient’s history, the first test is generally spirometry by having an assessment of bronchodilator response. If the test doesn’t read the diagnosis, however the index of suspicion for bronchial asthma continues to be high, measurement of FeNO might be useful to rule in disease although will still miss some patients with bronchial asthma.”

Investigators evaluated FeNO data in the selected studies and categorized the outcomes into four cutoff values, under 20 ppb, 20 to 29 ppb, 30 to 39 ppb, and 40 ppb and also over. Patients were also split into two age ranges, individuals over the age of 18 and individuals aged between 5 and 18.

For patients over 18, sensitivity decreased from .80 at <20 ppb, 0.69 at 20-29 ppb, 0.53 at 30-39 ppb to 0.41 at>40 ppb. Specificity values were .64, .78, .85, and .93, correspondingly. Cutoff values alter the sensitivity and specificity from the FeNO test. Lower cutoffs capture more and more people with disease but additionally cause more false good results.  

Based on Dr. Murad, “There’s not one test that may identify bronchial asthma. FeNO can be a useful tool that helps with diagnosis. However, patients’ history, physical exam, reaction to treatment along with other lung function tests remain required to complete the puzzle making diagnosing. Future research is required to figure out how FeNO may be used along with other biomarkers with hopefully better precision that may give a more definitive diagnosis.”

Source:

https://world wide web.elsevier.com/

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