Details

Autor(en) / Beteiligte

• Song, Woo-Jung, MD
• Kim, Hyun Jung, MPH, PhD
• Shim, Ji-Su, MD
• Won, Ha-Kyeong, MD
• Kang, Sung-Yoon, MD
• Sohn, Kyoung-Hee, MD
• Kim, Byung-Keun, MD
• Jo, Eun-Jung, MD
• Kim, Min-Hye, MD, PhD
• Kim, Sang-Heon, MD, PhD
• Park, Heung-Woo, MD, PhD
• Kim, Sun-Sin, MD, PhD
• Chang, Yoon-Seok, MD, PhD
• Morice, Alyn H., MD, FRCP
• Lee, Byung-Jae, MD, PhD
• Cho, Sang-Heon, MD, PhD

Titel

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

Ist Teil von

• Journal of allergy and clinical immunology, 2017-09, Vol.140 (3), p.701-709

Ort / Verlag

United States: Elsevier Inc

Erscheinungsjahr

2017

Quelle

MEDLINE

Beschreibungen/Notizen

• Background Individual studies have suggested the utility of fractional exhaled nitric oxide (F eno ) 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 F eno 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 F eno 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 F eno measurement. Results A total of 15 studies involving 2187 adults with chronic cough were identified. F eno 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 F eno measurement as a rule-in test for detecting CVA in adult patients with chronic cough. However, F eno measurement may not be useful to predict EB in nonasthmatic subjects with chronic cough. These findings warrant further studies to validate the roles of F eno measurement in clinical practice of patients with chronic cough.