Use of Fractional Exhaled Nitric Oxide to Guide the Treatment of Asthma: An Official American Thoracic Society Clinical Practice Guideline.
Use of Fractional Exhaled Nitric Oxide to Guide the Treatment of Asthma: An Official American Thoracic Society Clinical Practice Guideline.
复制标题
使用呼气一氧化氮分数指导哮喘治疗：美国胸科学会官方临床实践指南。
DOI：
10.1164/rccm.202109-2093st
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发表时间：
2021-11-15
影响因子：
24.7
通讯作者：
American Thoracic Society Assembly on Allergy, Immunology, and Inflammation
中科院分区：
文献类型：
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作者：
Khatri SB;Iaccarino JM;Barochia A;Soghier I;Akuthota P;Brady A;Covar RA;Debley JS;Diamant Z;Fitzpatrick AM;Kaminsky DA;Kenyon NJ;Khurana S;Lipworth BJ;McCarthy K;Peters M;Que LG;Ross KR;Schneider-Futschik EK;Sorkness CA;Hallstrand TS;American Thoracic Society Assembly on Allergy, Immunology, and Inflammation
背景：呼气一氧化氮分数（FENO）检测是一种用于评估哮喘的即时检测。目的：提供基于证据的临床指导，以确定FENO检测是否适用于正在考虑治疗的哮喘患者的哮喘治疗。研究方法：召开了一次国际多学科专家小组会议，以便就与使用FENO有关的一个问题形成一份共识文件。该问题是根据对临床实践的最大感知影响以及与该问题相关的循证答案的未满足需求从三个潜在问题中选择的。该小组对2004年至2019年期间发表的随机对照试验进行了系统评价，并遵循建议、评估、发展和评价分级（GRADE）证据决策框架制定建议。所有小组成员都评价并批准了这些建议。主要结果：在考虑到证据的整体质量较低后，专家组提出了基于FENO的护理的有条件建议。在正在考虑治疗的哮喘患者中，我们建议FENO是有益的，应在常规护理之外使用。这一判断是基于可能有利于干预的效果平衡;可能有利于干预的适度成本和资源可用性;以及干预在日常实践中的可接受性和可行性。结论：临床医生应考虑这一建议，以衡量FENO的哮喘患者，其中治疗正在考虑根据目前最好的证据。
Background: The fractional exhaled nitric oxide (FENO) test is a point-of-care test that is used in the assessment of asthma. Objective: To provide evidence-based clinical guidance on whether FENO 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 FENO. 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 FENO-based care. In patients with asthma in whom treatment is being considered, we suggest that FENO 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 FENO in patients with asthma in whom treatment is being considered based on current best available evidence.