Predictive Value of Nasal Nitric Oxide for Diagnosing Eosinophilic Chronic Rhinosinusitis: A Systematic Review and Meta-Analysis

IF 2.5 3区医学 Q1 OTORHINOLARYNGOLOGY

American Journal of Rhinology & Allergy Pub Date : 2024-04-29 DOI:10.1177/19458924241251387

Do Hyun Kim, Hyesoo Shin, Gulnaz Stybayeva, Se Hwan Hwang

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Abstract

ObjectivesThe primary aim of this study was to assess disparities in nasal nitric oxide (NO) levels between individuals diagnosed with eosinophilic chronic rhinosinusitis (ECRS) and those without ECRS. The second aim was to ascertain the comparative predictive efficacy of these nasal NO levels for the presence of ECRS.MethodsA systematic analysis was conducted on relevant studies that compared nasal NO levels in individuals with ECRS and those without. Furthermore, the discriminatory capacity of nasal NO in distinguishing ECRS from non-ECRS cohorts was quantified. The risk of bias across studies was evaluated utilizing the Newcastle-Ottawa scale.ResultsThe comprehensive review encompassed a total of 5 studies involving 470 participants. Findings revealed that patients diagnosed with ECRS exhibited significantly higher levels of nasal NO, as measured in parts per billion (ppb), compared to their non-ECRS patients. The mean difference was 130.03 ppb (95% confidence interval: [66.30, 193.75], I2 = 58.7%). The diagnostic odds ratio for nasal NO in identifying ECRS was 9.29 ([5.85, 14.75], I2 = 26.4%). The area under the summary receiver operating characteristic curve was 0.82. The correlation between sensitivity and false positive rate was 0.53, suggesting a lack of heterogeneity. Sensitivity, specificity, negative predictive value, and positive predictive value were 69% ([0.55, 0.79], I2 = 77.0%), 83% ([0.73, 0.90], I 2 = 68.5%), 77% ([0.69, 0.83], I 2 = 50.1%), and 75% ([0.67, 0.82], I 2 = 41.5%), respectively.ConclusionNasal NO has the potential as a noninvasive diagnostic measure and endotype tool for ECRS.

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鼻腔一氧化氮对诊断嗜酸性粒细胞性慢性鼻炎的预测价值：系统回顾与元分析

本研究的主要目的是评估被诊断为嗜酸性粒细胞慢性鼻炎（ECRS）患者和非ECRS患者之间鼻腔一氧化氮（NO）水平的差异。方法对比较 ECRS 患者和非 ECRS 患者鼻腔一氧化氮水平的相关研究进行了系统分析。此外，还量化了鼻腔 NO 在区分 ECRS 和非 ECRS 群体方面的鉴别能力。采用纽卡斯尔-渥太华量表对各项研究的偏倚风险进行了评估。研究结果显示，与非 ECRS 患者相比，确诊为 ECRS 的患者鼻腔 NO 水平（以十亿分之一（ppb）为单位）明显更高。平均差异为 130.03 ppb（95% 置信区间：[66.30, 193.75]，I2 = 58.7%）。鼻腔 NO 识别 ECRS 的诊断几率比为 9.29（[5.85, 14.75]，I2 = 26.4%）。接收者操作特征曲线下面积为 0.82。灵敏度与假阳性率之间的相关性为 0.53，表明缺乏异质性。灵敏度、特异性、阴性预测值和阳性预测值分别为 69%（[0.55, 0.79]，I2 = 77.0%）、83%（[0.73, 0.90]，I 2 = 68.5%）、77%（[0.69, 0.83]，I 2 = 50.1%）和 75%（[0.67, 0.82]，I 2 = 41.5%）。

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来源期刊

American Journal of Rhinology & Allergy 医学-耳鼻喉科学

CiteScore

5.60

自引率

11.50%

发文量

审稿时长

4-8 weeks

期刊介绍： The American Journal of Rhinology & Allergy is a peer-reviewed, scientific publication committed to expanding knowledge and publishing the best clinical and basic research within the fields of Rhinology & Allergy. Its focus is to publish information which contributes to improved quality of care for patients with nasal and sinus disorders. Its primary readership consists of otolaryngologists, allergists, and plastic surgeons. Published material includes peer-reviewed original research, clinical trials, and review articles.