Asthma and lower airway diseaseDiagnostic 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
Section snippets
Search strategy
We conducted a systematic literature search to identify studies that had relevant information for the following 3 research questions (RQs):
“What is the diagnostic accuracy of Feno (index test) for CVA and/or EB (reference standard) in patients with chronic cough (target condition)?”
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RQ1: Feno for CVA in patients with chronic cough;
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RQ2: Feno measurement for either CVA or EB in patients with chronic cough; and
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RQ3: Feno measurement for EB in nonasthmatic patients with chronic cough.
We searched the
Study characteristics and methodological quality
In total, 15 studies involving 2187 adult patients with chronic cough were identified to respond to one of the 3 RQs (Fig 1). Baseline characteristics of the 15 included studies are summarized in Table E1 and the Results section in this article's Online Repository at www.jacionline.org. Fourteen studies were published as full articles,14, 15, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34 and 1 was a conference abstract.35 Most of the studies were conducted in Asia (10/15; 8 in China, 1 in
Discussion
Feno values can reflect TH2 airway inflammation, which might help define the TH2 endotype of chronic cough. Here we identified the diagnostic potential of Feno measurement in predicting 2 major TH2 inflammatory conditions underlying chronic cough: CVA and EB. We found that Feno measurements had moderate diagnostic accuracy in predicting CVA in adult patients with chronic cough. The estimated summary AUCs ranged from 0.81 to 0.89, according to the RQ, or in subgroup analyses. Sensitivities were
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Supported by grant no. 23-2015-0200 from the SNUH Research Fund.
Disclosure of potential conflict of interest: W.-J. Song receives grant support from Seoul National University Hospital. The rest of the authors declare that they have no relevant conflicts of interest.