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Diagnostic accuracy of fractional exhaled nitric oxide measurement in predicting cough-variant asthma and eosinophilic bronchitis in adults with chronic cough: A systematic review and meta-analysis

Title
Diagnostic accuracy of fractional exhaled nitric oxide measurement in predicting cough-variant asthma and eosinophilic bronchitis in adults with chronic cough: A systematic review and meta-analysis
Authors
Song W.-J.Kim H.J.Shim J.-S.Won H.-K.Kang S.-Y.Sohn K.-H.Kim B.-K.Jo E.-J.Kim M.-H.Kim S.-H.Park H.-W.Kim S.-S.Chang Y.-S.Morice A.H.Lee B.-J.Cho S.-H.
Ewha Authors
김민혜
SCOPUS Author ID
김민혜scopus
Issue Date
2017
Journal Title
Journal of Allergy and Clinical Immunology
ISSN
0091-6749JCR Link
Citation
vol. 140, no. 3, pp. 701 - 709
Keywords
asthmaChronic cougheosinophilic bronchitisfractional exhaled nitric oxidesystematic review
Publisher
Mosby Inc.
Indexed
SCI; SCIE; SCOPUS WOS scopus
Abstract
Background Individual studies have suggested the utility of fractional exhaled nitric oxide (FENO) measurement in detecting cough-variant asthma (CVA) and eosinophilic bronchitis (EB) in patients with chronic cough. Objective We sought to obtain summary estimates of diagnostic test accuracy of FENO measurement in predicting CVA, EB, or both in adults with chronic cough. Methods Electronic databases were searched for studies published until January 2016, without language restriction. Cross-sectional studies that reported the diagnostic accuracy of FENO measurement for detecting CVA or EB were included. Risk of bias was assessed with Quality Assessment of Diagnostic Accuracy Studies 2. Random effects meta-analyses were performed to obtain summary estimates of the diagnostic accuracy of FENO measurement. Results A total of 15 studies involving 2187 adults with chronic cough were identified. FENO measurement had a moderate diagnostic accuracy in predicting CVA in patients with chronic cough, showing the summary area under the curve to be 0.87 (95% CI, 0.83-0.89). Specificity was higher and more consistent than sensitivity (0.85 [95% CI, 0.81-0.88] and 0.72 [95% CI, 0.61-0.81], respectively). However, in the nonasthmatic population with chronic cough, the diagnostic accuracy to predict EB was found to be relatively lower (summary area under the curve, 0.81 [95% CI, 0.77-0.84]), and specificity was inconsistent. Conclusions The present meta-analyses indicated the diagnostic potential of FENO measurement as a rule-in test for detecting CVA in adult patients with chronic cough. However, FENO measurement may not be useful to predict EB in nonasthmatic subjects with chronic cough. These findings warrant further studies to validate the roles of FENO measurement in clinical practice of patients with chronic cough. © 2017 American Academy of Allergy, Asthma & Immunology
DOI
10.1016/j.jaci.2016.11.037
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의료원 > 의료원 > Journal papers
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