Abstract：
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.
摘要：
背景：呼出气一氧化氮（FENO）测试是一种用于哮喘评估的即时测试。目的：为正在考虑治疗的哮喘患者提供FENO检测是否可用于优化哮喘治疗的循证临床指导。方法：国际，召集了多学科专家小组，以就与使用FENO有关的单个问题达成共识文件。根据对临床实践的最大感知影响以及对与此问题相关的基于证据的答案的未满足需求，从三个潜在问题中选择了该问题。小组对2004年至2019年之间已发表的随机对照试验进行了系统评价，并遵循了建议的分级，评估,发展,和评估（等级）证据决策框架，以制定建议。所有小组成员都评估并批准了建议。主要结果：在考虑到证据的总体质量低后，小组对基于FENO的护理提出了有条件的建议.在考虑治疗的哮喘患者中，我们建议FENO是有益的，除了常规护理外，还应使用。这一判断基于可能有利于干预的效果平衡；适度的成本和资源的可用性，这可能有利于干预；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来测量哮喘患者的FENO，这些患者正在考虑根据现有的最佳证据进行治疗。
