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  • Diagnostic accuracy of frac...
    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

    Journal of allergy and clinical immunology, 09/2017, Letnik: 140, Številka: 3
    Journal Article

    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.