Background The National Review of Asthma Deaths UK highlighted that 46% of deaths could be avoided and recommended that all sufferers receive a structured asthma annual review which assess asthma control. In primary care this is commonly achieved using symptom-based questionnaires such as the Asthma Control Test (ACT). A newer method of assessing asthma control is Fractional Exhaled Nitric Oxide (FeNO) testing, which is currently recommended for the diagnosis of asthma, but not for monitoring of asthma control. The study aim was to assess the correlation between self-reported symptoms as measured by the ACT and FeNO testing and the subsequent impact of FeNO testing on prescribing of asthma medication. Methods A retrospective review of 65 patients who had received both ACT and FeNO testing as part of their asthma annual review. A spearman correlation was used to estimate the correlation between ACT scores and FENO levels. A χ2 test was used to compare prompting frequency of the measures and Kendalls τ statistic was made to estimate their concordance and influence on subsequent ICS medication prescription. Results The mean age of the participants was 41 years (4-93 years). There was no statistically significant correlation between ACT and FeNO (ρ = 0.195, p = 0.120). The median FeNO was 26 ppb (range 8-279 ppb), and the ACT score 20 (range 5 to 25 points). Furthermore, FeNO more frequently prompts a change in medication than ACT, 66% versus 42% (p = 0.005). A low concordance between the measures was found (Kendall's τ statistic - 0.321). Conclusion FeNO should be considered for monitoring of control in asthma. To balance the cost of implementing this technology into primary care a risk stratified approach could be applied to testing.

中文翻译：

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自我报告的哮喘症状与呼出的一氧化氮水平之间的一致性：对全科实践中吸入皮质类固醇处方的影响。一项观察性研究。


背景 英国哮喘死亡国家审查强调，46% 的死亡是可以避免的，并建议所有患者接受结构化哮喘年度审查，以评估哮喘控制情况。在初级保健中，这通常是使用基于症状的问卷调查来实现的，例如哮喘控制测试（ACT）。评估哮喘控制情况的一种新方法是呼出一氧化氮分数 (FeNO) 测试，目前推荐用于诊断哮喘，但不用于监测哮喘控制情况。该研究的目的是评估 ACT 和 FeNO 测试测量的自我报告症状之间的相关性以及 FeNO 测试对哮喘药物处方的后续影响。方法 对 65 名接受 ACT 和 FeNO 测试作为哮喘年度审查一部分的患者进行回顾性审查。使用斯皮尔曼相关性来估计 ACT 分数和 FENO 水平之间的相关性。采用 χ2 检验比较措施的提示频率，并进行 Kendalls τ 统计来估计其一致性以及对后续 ICS 药物处方的影响。结果 参与者的平均年龄为 41 岁（4-93 岁）。 ACT 和 FeNO 之间不存在统计学显着相关性（ρ = 0.195，p = 0.120）。 FeNO 中位数为 26 ppb（范围 8-279 ppb），ACT 评分为 20（范围 5 至 25 分）。此外，FeNO 比 ACT 更频繁地促使药物改变，分别为 66% 和 42% (p = 0.005)。发现测量值之间的一致性较低（Kendall 的 τ 统计量 - 0.321）。结论 应考虑使用 FeNO 来监测哮喘的控制情况。为了平衡将该技术应用于初级保健的成本，可以采用风险分层方法进行测试。