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Use of Fractional Exhaled Nitric Oxide to Guide the Treatment of Asthma: An Official American Thoracic Society Clinical Practice Guideline
Background: The fractional exhaled nitric oxide (FE(NO)) test is a point-of-care test that is used in the assessment of asthma. Objective: To provide evidence-based clinical guidance on whether FE(NO) testing is indicated to optimize asthma treatment in patients with asthma in whom treatment is bein...
Autores principales: | , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
American Thoracic Society
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8759314/ https://www.ncbi.nlm.nih.gov/pubmed/34779751 http://dx.doi.org/10.1164/rccm.202109-2093ST |
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author | Khatri, Sumita B. Iaccarino, Jonathan M. Barochia, Amisha Soghier, Israa Akuthota, Praveen Brady, Anna Covar, Ronina A. Debley, Jason S. Diamant, Zuzana Fitzpatrick, Anne M. Kaminsky, David A. Kenyon, Nicholas J. Khurana, Sandhya Lipworth, Brian J. McCarthy, Kevin Peters, Michael Que, Loretta G. Ross, Kristie R. Schneider-Futschik, Elena K. Sorkness, Christine A. Hallstrand, Teal S. |
author_facet | Khatri, Sumita B. Iaccarino, Jonathan M. Barochia, Amisha Soghier, Israa Akuthota, Praveen Brady, Anna Covar, Ronina A. Debley, Jason S. Diamant, Zuzana Fitzpatrick, Anne M. Kaminsky, David A. Kenyon, Nicholas J. Khurana, Sandhya Lipworth, Brian J. McCarthy, Kevin Peters, Michael Que, Loretta G. Ross, Kristie R. Schneider-Futschik, Elena K. Sorkness, Christine A. Hallstrand, Teal S. |
author_sort | Khatri, Sumita B. |
collection | PubMed |
description | Background: The fractional exhaled nitric oxide (FE(NO)) test is a point-of-care test that is used in the assessment of asthma. Objective: To provide evidence-based clinical guidance on whether FE(NO) testing is indicated to optimize asthma treatment in patients with asthma in whom treatment is being considered. Methods: An international, multidisciplinary panel of experts was convened to form a consensus document regarding a single question relevant to the use of FE(NO). The question was selected from three potential questions based on the greatest perceived impact on clinical practice and the unmet need for evidence-based answers related to this question. The panel performed systematic reviews of published randomized controlled trials between 2004 and 2019 and followed the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) evidence-to-decision framework to develop recommendations. All panel members evaluated and approved the recommendations. Main Results: After considering the overall low quality of the evidence, the panel made a conditional recommendation for FE(NO)-based care. In patients with asthma in whom treatment is being considered, we suggest that FE(NO) is beneficial and should be used in addition to usual care. This judgment is based on a balance of effects that probably favors the intervention; the moderate costs and availability of resources, which probably favors the intervention; and the perceived acceptability and feasibility of the intervention in daily practice. Conclusions: Clinicians should consider this recommendation to measure FE(NO) in patients with asthma in whom treatment is being considered based on current best available evidence. |
format | Online Article Text |
id | pubmed-8759314 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | American Thoracic Society |
record_format | MEDLINE/PubMed |
spelling | pubmed-87593142022-01-14 Use of Fractional Exhaled Nitric Oxide to Guide the Treatment of Asthma: An Official American Thoracic Society Clinical Practice Guideline Khatri, Sumita B. Iaccarino, Jonathan M. Barochia, Amisha Soghier, Israa Akuthota, Praveen Brady, Anna Covar, Ronina A. Debley, Jason S. Diamant, Zuzana Fitzpatrick, Anne M. Kaminsky, David A. Kenyon, Nicholas J. Khurana, Sandhya Lipworth, Brian J. McCarthy, Kevin Peters, Michael Que, Loretta G. Ross, Kristie R. Schneider-Futschik, Elena K. Sorkness, Christine A. Hallstrand, Teal S. Am J Respir Crit Care Med American Thoracic Society Documents Background: The fractional exhaled nitric oxide (FE(NO)) test is a point-of-care test that is used in the assessment of asthma. Objective: To provide evidence-based clinical guidance on whether FE(NO) testing is indicated to optimize asthma treatment in patients with asthma in whom treatment is being considered. Methods: An international, multidisciplinary panel of experts was convened to form a consensus document regarding a single question relevant to the use of FE(NO). The question was selected from three potential questions based on the greatest perceived impact on clinical practice and the unmet need for evidence-based answers related to this question. The panel performed systematic reviews of published randomized controlled trials between 2004 and 2019 and followed the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) evidence-to-decision framework to develop recommendations. All panel members evaluated and approved the recommendations. Main Results: After considering the overall low quality of the evidence, the panel made a conditional recommendation for FE(NO)-based care. In patients with asthma in whom treatment is being considered, we suggest that FE(NO) is beneficial and should be used in addition to usual care. This judgment is based on a balance of effects that probably favors the intervention; the moderate costs and availability of resources, which probably favors the intervention; and the perceived acceptability and feasibility of the intervention in daily practice. Conclusions: Clinicians should consider this recommendation to measure FE(NO) in patients with asthma in whom treatment is being considered based on current best available evidence. American Thoracic Society 2021-03-30 /pmc/articles/PMC8759314/ /pubmed/34779751 http://dx.doi.org/10.1164/rccm.202109-2093ST Text en Copyright © 2021 by the American Thoracic Society https://creativecommons.org/licenses/by-nc-nd/4.0/You may print one copy of this document at no charge. However, if you require more than one copy, you must place a reprint order. Domestic reprint orders: amy.schriver@sheridan.com; international reprint orders: louisa.mott@springer.com. |
spellingShingle | American Thoracic Society Documents Khatri, Sumita B. Iaccarino, Jonathan M. Barochia, Amisha Soghier, Israa Akuthota, Praveen Brady, Anna Covar, Ronina A. Debley, Jason S. Diamant, Zuzana Fitzpatrick, Anne M. Kaminsky, David A. Kenyon, Nicholas J. Khurana, Sandhya Lipworth, Brian J. McCarthy, Kevin Peters, Michael Que, Loretta G. Ross, Kristie R. Schneider-Futschik, Elena K. Sorkness, Christine A. Hallstrand, Teal S. Use of Fractional Exhaled Nitric Oxide to Guide the Treatment of Asthma: An Official American Thoracic Society Clinical Practice Guideline |
title | Use of Fractional Exhaled Nitric Oxide to Guide the Treatment of Asthma: An Official American Thoracic Society Clinical Practice Guideline |
title_full | Use of Fractional Exhaled Nitric Oxide to Guide the Treatment of Asthma: An Official American Thoracic Society Clinical Practice Guideline |
title_fullStr | Use of Fractional Exhaled Nitric Oxide to Guide the Treatment of Asthma: An Official American Thoracic Society Clinical Practice Guideline |
title_full_unstemmed | Use of Fractional Exhaled Nitric Oxide to Guide the Treatment of Asthma: An Official American Thoracic Society Clinical Practice Guideline |
title_short | Use of Fractional Exhaled Nitric Oxide to Guide the Treatment of Asthma: An Official American Thoracic Society Clinical Practice Guideline |
title_sort | use of fractional exhaled nitric oxide to guide the treatment of asthma: an official american thoracic society clinical practice guideline |
topic | American Thoracic Society Documents |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8759314/ https://www.ncbi.nlm.nih.gov/pubmed/34779751 http://dx.doi.org/10.1164/rccm.202109-2093ST |
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