Skip to main content

Research Repository

Advanced Search

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

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

Authors

Woo Jung Song

Hyun Jung Kim

Ji Su Shim

Ha Kyeong Won

Sung Yoon Kang

Kyoung Hee Sohn

Byung Keun Kim

Eun Jung Jo

Min Hye Kim

Sang Heon Kim

Heung Woo Park

Sun Sin Kim

Yoon Seok Chang

Byung Jae Lee

Sang Heon Cho



Abstract

© 2017 American Academy of Allergy, Asthma & Immunology 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.

Citation

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. (2017). 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. Journal of Allergy and Clinical Immunology, 140(3), 701-709. https://doi.org/10.1016/j.jaci.2016.11.037

Journal Article Type Article
Acceptance Date Nov 2, 2016
Online Publication Date Jan 11, 2017
Publication Date 2017-09
Deposit Date May 10, 2022
Journal Journal of Allergy and Clinical Immunology
Print ISSN 0091-6749
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 140
Issue 3
Pages 701-709
DOI https://doi.org/10.1016/j.jaci.2016.11.037
Keywords Chronic cough; Fractional exhaled nitric oxide; Asthma; Eosinophilic bronchitis; Systematic review
Public URL https://hull-repository.worktribe.com/output/3609791