Please use this identifier to cite or link to this item: doi:10.22028/D291-39808
Title: Diagnostic accuracy of FeNO [fractional exhaled nitric oxide] and asthma symptoms increased when evaluated with a superior reference standard
Author(s): Kellerer, Christina
Wagenpfeil, Stefan
Daines, Luke
Jörres, Rudolf A
Hapfelmeier, Alexander
Schneider, Antonius
Language: English
Title: Journal of clinical epidemiology
Volume: 129
Pages: 86-96
Publisher/Platform: Elsevier
Year of Publication: 2020
Free key words: Asthma
Diagnostic study
Area under the curve
Fractional exhaled nitric oxide
DDC notations: 610 Medicine and health
Publikation type: Journal Article
Abstract: Objectives: The objective of the study is to determine the impact of changing reference standards (RS), namely spirometry vs. whole-body plethysmography (WBP), on estimation of the diagnostic accuracy of fractional exhaled nitric oxide (FeNO) and clinical signs and symptoms (CSS) as index tests regarding asthma diagnosis. Study Design and Setting: This was a diagnostic study conducted in 393 patients attending a private practice of pneumologists with complaints suspicious of asthma. First, the index tests were compared with the diagnostic results of spirometry in terms of forced expiratory volume in the first second (FEV1) responsiveness. Second, the index tests were compared with the results of WBP in terms of specific airway resistance and FEV1 responsiveness. Areas under the curve (AUC) were compared with a generalized estimating equation approach based on binary logistic regression. Results: FeNO values and CSS ‘wheezing’ and ‘allergic rhinitis’ showed higher specificities (P < 0.001) and sensitivities (not significant) when evaluated with WBP; also, Youden indices increased in these CSS (P < 0.05). AUC of FeNO in combination with ‘wheezing’ and ‘allergic rhinitis’ when WBP was used as RS (AUC = 0.724; 95% confidence interval 0.672 to 0.776) was higher compared with spirometry as RS (AUC = 0.654; 95% confidence interval 0.585 to 0.722) (P < 0.001). Conclusion: In case of asthma, superior RS led to more favorable assessment of index tests. FeNO measurement might have been underestimated in some previous studies.
DOI of the first publication: 10.1016/j.jclinepi.2020.09.021
URL of the first publication:
Link to this record: urn:nbn:de:bsz:291--ds-398087
ISSN: 0895-4356
Date of registration: 22-May-2023
Description of the related object: Supplemental Material
Related object:
Faculty: M - Medizinische Fakultät
Department: M - Medizinische Biometrie, Epidemiologie und medizinische Informatik
Professorship: M - Prof. Dr. Stefan Wagenpfeil
Collections:SciDok - Der Wissenschaftsserver der Universität des Saarlandes

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