help button home button
AJRCCM
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH
Published ahead of print on November 25, 2003, doi:10.1164/rccm.200310-1376OC

Am. J. Respir. Crit. Care Med., Volume 169, Number 4, February 2004, 473-478

A more recent version of this article appeared on February 15, 2004
This Article
Right arrow Full Text (PDF)
Right arrow All Versions of this Article:
200310-1376OCv1
169/4/473    most recent
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Smith, A. D
Right arrow Articles by Taylor, D. R.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Smith, A. D
Right arrow Articles by Taylor, D. R.

Submitted on October 13, 2003
Accepted on November 24, 2003

Diagnosing asthma: comparisons between exhaled nitric oxide measurements and conventional tests

Andrew D Smith1, Jan O Cowan1, Sue Filsell1, Chris McLachlan1, Gabrielle Monti-Sheehan1, Pamela Jackson1, and D. Robin Taylor1*

1 Otago Respiratory Research Unit, Dunedin School of Medicine, University of Otago, Dunedin, Otago, New Zealand

* To whom correspondence should be addressed. E-mail: robin.taylor{at}stonebow.otago.ac.nz.

International guidelines recommend a range of clinical tests to confirm the diagnosis of asthma. These focus largely on identifying variable airflow obstruction and responses to bronchodilator or corticosteroid. More recently, the use of exhaled nitric oxide (FENO) measurements and induced sputum analysis to assess airway inflammation have been highlighted. However, to date, no systematic comparisons to confirm the diagnostic utility of each of these methods have been carried out. To do so, we investigated 47 consecutive patients with symptoms suggestive of asthma using a comprehensive fixed-sequence series of diagnostic tests. Sensitivities and specificities were obtained for peak flow measurements, spirometry, and changes in these parameters following a trial of steroid. Comparisons were made against FENO and sputum cell counts. Sensitivities for each of the conventional tests (0 - 47%) were lower than for FENO (88%) and sputum eosinophils (86%). Overall, the diagnostic accuracy using FENO and sputum eosinophils was significantly greater. Results for conventional tests were not improved using a trial of steroid. We conclude that FENO measurements and induced sputum analysis are superior to conventional approaches, with the advantage for exhaled nitric oxide that the test is quick and easy to perform.
Key words: Asthma, diagnosis, lung function, exhaled nitric oxide, induced sputum




This article has been cited by other articles:


Home page
 ChestHome page
S. Ferrazzoni, M. C. Scarpa, G. Guarnieri, M. Corradi, A. Mutti, and P. Maestrelli
Exhaled Nitric Oxide and Breath Condensate pH in Asthmatic Reactions Induced by Isocyanates
Chest, July 1, 2009; 136(1): 155 - 162.
[Abstract] [Full Text] [PDF]

Home page
 Chronic Respiratory DiseaseHome page
G. Rodway, J Choi, L. Hoffman, and J. Sethi
Exhaled nitric oxide in the diagnosis and management of asthma: clinical implications
Chronic Respiratory Disease, February 1, 2009; 6(1): 19 - 29.
[Abstract] [PDF]

Home page
 Eur Respir JHome page
S. Holgate, H. Bisgaard, L. Bjermer, T. Haahtela, J. Haughney, R. Horne, A. McIvor, S. Palkonen, D. B. Price, M. Thomas, et al.
The Brussels Declaration: the need for change in asthma management
Eur. Respir. J., December 1, 2008; 32(6): 1433 - 1442.
[Abstract] [Full Text] [PDF]

Home page
 Postgrad. Med. J.Home page
D R Taylor and I D Pavord
Biomarkers in the assessment and management of airways diseases
Postgrad. Med. J., December 1, 2008; 84(998): 628 - 634.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
K. G. Lim and C. Mottram
The Use of Fraction of Exhaled Nitric Oxide in Pulmonary Practice
Chest, May 1, 2008; 133(5): 1232 - 1242.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
N. M. Grob and R. A. Dweik
Exhaled Nitric Oxide in Asthma: From Diagnosis, to Monitoring, to Screening: Are We There Yet?
Chest, April 1, 2008; 133(4): 837 - 839.
[Full Text] [PDF]

Home page
 ChestHome page
K. Kostikas, A. I. Papaioannou, K. Tanou, A. Koutsokera, M. Papala, and K. I. Gourgoulianis
Portable Exhaled Nitric Oxide as a Screening Tool for Asthma in Young Adults During Pollen Season
Chest, April 1, 2008; 133(4): 906 - 913.
[Abstract] [Full Text] [PDF]

Home page
 Mayo Clin Proc.Home page
P. Y. Hahn, T. I. Morgenthaler, and K. G. Lim
Use of Exhaled Nitric Oxide in Predicting Response to Inhaled Corticosteroids for Chronic Cough
Mayo Clin. Proc., November 1, 2007; 82(11): 1350 - 1355.
[Abstract] [Full Text] [PDF]

Home page
 Eur Respir JHome page
B. Balbi, P. Pignatti, M. Corradi, P. Baiardi, L. Bianchi, G. Brunetti, A. Radaeli, G. Moscato, A. Mutti, A. Spanevello, et al.
Bronchoalveolar lavage, sputum and exhaled clinically relevant inflammatory markers: values in healthy adults
Eur. Respir. J., October 1, 2007; 30(4): 769 - 781.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
J. Travers, S. Marsh, S. Aldington, M. Williams, P. Shirtcliffe, A. Pritchard, M. Weatherall, and R. Beasley
Reference Ranges for Exhaled Nitric Oxide Derived from a Random Community Survey of Adults
Am. J. Respir. Crit. Care Med., August 1, 2007; 176(3): 238 - 242.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
D. E. Shaw, M. A. Berry, M. Thomas, R. H. Green, C. E. Brightling, A. J. Wardlaw, and I. D. Pavord
The Use of Exhaled Nitric Oxide to Guide Asthma Management: A Randomized Controlled Trial
Am. J. Respir. Crit. Care Med., August 1, 2007; 176(3): 231 - 237.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
D. Miedinger, P. N. Chhajed, M. Tamm, D. Stolz, C. Surber, and J. D. Leuppi
Diagnostic Tests for Asthma in Firefighters
Chest, June 1, 2007; 131(6): 1760 - 1767.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
P. Latzin, C. E. Kuehni, D. N. Baldwin, H. L. Roiha, C. Casaulta, and U. Frey
Elevated Exhaled Nitric Oxide in Newborns of Atopic Mothers Precedes Respiratory Symptoms
Am. J. Respir. Crit. Care Med., December 15, 2006; 174(12): 1292 - 1298.
[Abstract] [Full Text] [PDF]

Home page
 ThoraxHome page
D R Taylor, M W Pijnenburg, A D Smith, and J C D Jongste
Exhaled nitric oxide measurements: clinical application and interpretation
Thorax, September 1, 2006; 61(9): 817 - 827.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
A. F. Gelb, C. Flynn Taylor, C. M. Shinar, C. Gutierrez, and N. Zamel
Role of Spirometry and Exhaled Nitric Oxide To Predict Exacerbations in Treated Asthmatics
Chest, June 1, 2006; 129(6): 1492 - 1499.
[Abstract] [Full Text] [PDF]

Home page
 Biol Res NursHome page
J. Choi, L. A. Hoffman, G. W. Rodway, and J. M. Sethi
Markers of lung disease in exhaled breath: nitric oxide.
Biol Res Nurs, April 1, 2006; 7(4): 241 - 255.
[Abstract] [PDF]

Home page
 ChestHome page
A.-M. Vints, E. Oostveen, G. Eeckhaut, M. Smolders, and W. A. De Backer
Time-Dependent Effect of Nitrate-Rich Meals on Exhaled Nitric Oxide in Healthy Subjects
Chest, October 1, 2005; 128(4): 2465 - 2470.
[Abstract] [Full Text] [PDF]

Home page
 Eur Respir JHome page
O. Holz
Catching breath: monitoring airway inflammation using exhaled breath condensate
Eur. Respir. J., September 1, 2005; 26(3): 371 - 372.
[Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
A. D. Smith, J. O. Cowan, K. P. Brassett, S. Filsell, C. McLachlan, G. Monti-Sheehan, G. P. Herbison, and D. R. Taylor
Exhaled Nitric Oxide: A Predictor of Steroid Response
Am. J. Respir. Crit. Care Med., August 15, 2005; 172(4): 453 - 459.
[Abstract] [Full Text] [PDF]

Home page
 Chronic Respiratory DiseaseHome page
R Ratnawati and P S Thomas
Exhaled nitric oxide in paediatric asthma
Chronic Respiratory Disease, July 1, 2005; 2(3): 163 - 174.
[Abstract] [PDF]

Home page
 Eur Respir JHome page
P. E. Silkoff
Monitoring nitric oxide: here to stay for bench and bedside
Eur. Respir. J., June 1, 2005; 25(6): 949 - 950.
[Full Text] [PDF]

Home page
 ThoraxHome page
N Berkman, A Avital, R Breuer, E Bardach, C Springer, and S Godfrey
Exhaled nitric oxide in the diagnosis of asthma: comparison with bronchial provocation tests
Thorax, May 1, 2005; 60(5): 383 - 388.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
ATS/ERS Recommendations for Standardized Procedures for the Online and Offline Measurement of Exhaled Lower Respiratory Nitric Oxide and Nasal Nitric Oxide, 2005
Am. J. Respir. Crit. Care Med., April 15, 2005; 171(8): 912 - 930.
[Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
L. Fabbri, S. P. Peters, I. Pavord, S. E. Wenzel, S. C. Lazarus, W. MacNee, F. Lemaire, and E. Abraham
Allergic Rhinitis, Asthma, Airway Biology, and Chronic Obstructive Pulmonary Disease in AJRCCM in 2004
Am. J. Respir. Crit. Care Med., April 1, 2005; 171(7): 686 - 698.
[Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
A. F. Gelb, C. F. Taylor, E. Nussbaum, C. Gutierrez, A. Schein, C. M. Shinar, M. J. Schein, J. D. Epstein, and N. Zamel
Alveolar and Airway Sites of Nitric Oxide Inflammation in Treated Asthma
Am. J. Respir. Crit. Care Med., October 1, 2004; 170(7): 737 - 741.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
E. S. Taylor, A. D. Smith, J. O. Cowan, G. P. Herbison, and D. R. Taylor
Effect of Caffeine Ingestion on Exhaled Nitric Oxide Measurements in Patients with Asthma
Am. J. Respir. Crit. Care Med., May 1, 2004; 169(9): 1019 - 1021.
[Abstract] [Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH
Proc. Am. Thorac. Soc. Am. J. Respir. Cell Mol. Biol.
Copyright © 2003 American Thoracic Society 		  ATS Clinical Skills Tests