No full text
Article (Scientific journals)
Is FE(NO50) useful diagnostic tool in suspected asthma?
SCHLEICH, FLorence; ASANDEI, Raluca; Manise, Maïté et al.
2012In International Journal of Clinical Practice, 66 (2), p. 158-65
Peer Reviewed verified by ORBi
 

Files


Full Text
No document available.
Full Text Parts
Is FEN050 useful diagnostic tool in suspected asthma_Schleich_12_IntJClinPract.pdf
Publisher postprint (158.41 kB)
Request a copy
Is FEN050 useful diagnostic tool in suspected asthma_Schleich_12_IntJClinPract.pdf
Author postprint (355.16 kB)
Download

All documents in ORBi are protected by a user license.

Send to



Details



Abstract :
[en] Background: Asthma diagnosis is based on the presence of symptoms and the demonstration of airflow variability. Airway inflammation measured by fractional exhaled nitric oxide, measured at a flow rate of 50 ml/s (FE(NO50) ) remains a controversial diagnostic tool. Aim: To assess the ability of FE(NO50) to identify bronchial hyperresponsiveness (BHR) to methacholine (provocative concentration of methacholine causing a 20% fall in FEV(1) ; PC20M </= 16 mg/ml) and to establish whether or not symptoms relate to FE(NO50) and PC20M in patients with no demonstrated reversibility to beta(2) -agonist. Methods: We conducted a prospective study on 174 steroid naive patients with respiratory symptoms, forced expiratory volume in 1 s (FEV(1) ) >/= 70% predicted and no demonstrated reversibility to beta(2) -agonist. Patients answered to a standardised symptom questionnaire and underwent FE(NO50) and methacholine challenge. Receiver-operating characteristic (ROC) curve and logistic regression analysis assessed the relationship between PC20M and FE(NO50) , taking into account covariates (smoking, atopy, age, gender and FEV(1) ). Results: A total of 82 patients had a PC20M </= 16 mg/ml and had significantly higher FE(NO50) (19 ppb vs. 15 ppb; p < 0.05). By constructing ROC curve, we found that FE(NO50) cut-off value of 34 ppb was able to identify not only BHR with high specificity (95%) and positive predictive value (88%) but low sensitivity (35%) and negative predictive value (62%). When combining all variables into the logistic model, FE(NO50) (p = 0.0011) and FEV(1) (p < 0.0001) were independent predictors of BHR whereas age, gender, smoking and atopy had no influence. The presence of diurnal and nocturnal wheezing was associated with raised FE(NO50) (p < 0.001 and p < 0.05, respectively). Conclusion: The value of FE(NO50) > 34 ppb has high predictive value of PC20M < 16 in patients with suspected asthma in whom bronchodilating test failed to demonstrate reversibility or was not indicated. However, FE(NO50) </= 34 ppb does not rule out BHR and should prompt the clinician to ask for a methacholine challenge.
Disciplines :
Cardiovascular & respiratory systems
Author, co-author :
SCHLEICH, FLorence ;  Centre Hospitalier Universitaire de Liège - CHU > Pneumologie-Allergologie
ASANDEI, Raluca ;  Centre Hospitalier Universitaire de Liège - CHU > Pneumologie-Allergologie
Manise, Maïté ;  Université de Liège - ULiège > Département des sciences cliniques > Pneumologie - Allergologie
SELE, Jocelyne ;  Centre Hospitalier Universitaire de Liège - CHU > Pneumologie-Allergologie
Seidel, Laurence  ;  Université de Liège - ULiège > Département des sciences de la santé publique > Informatique médicale et biostatistique
LOUIS, Renaud ;  Centre Hospitalier Universitaire de Liège - CHU > Pneumologie-Allergologie
Language :
English
Title :
Is FE(NO50) useful diagnostic tool in suspected asthma?
Publication date :
2012
Journal title :
International Journal of Clinical Practice
ISSN :
1368-5031
eISSN :
1742-1241
Publisher :
Blackwell Publishing, Oxford, United Kingdom
Volume :
66
Issue :
2
Pages :
158-65
Peer reviewed :
Peer Reviewed verified by ORBi
Commentary :
(c) 2012 Blackwell Publishing Ltd.
Available on ORBi :
since 01 February 2012

Statistics


Number of views
184 (18 by ULiège)
Number of downloads
196 (8 by ULiège)

Scopus citations®
 
25
Scopus citations®
without self-citations
20
OpenCitations
 
20

Bibliography


Similar publications



Contact ORBi