Page 51 - ADULT-ONSET ASTHMA PREDICTORS OF CLINICAL COURSE AND SEVERITY

BIOMARKERS TO IDENTIFY SPUTUM EOSINOPHILIA IN DIFFERENT ADULT ASTHMA PHENOTYPES
49
Test Test
AUC AUC Positivity PositivitSyensitivitySensitivity SpecificitySpecificity PPV PPV
NPV NPV
TP FPTP
FNFP TNFN TN
Test
FeNO FeNO
threshold threshold
AUC Positivity Sensitivity Specificity PPV
0.82 (0.77-00.8.827()0.77-0≥.1827.)2 ppb≥12.2 pp0b.96 [0.90,00.9.969[]0.90, 0.9298][0.22,00.2.384[]0.22, 0.4314][0.35,00.4.417[]0.35,
NPV 0.4972][0.82,00.9.927[]0.82,
TP FP 10.0987] 151408
FN TN
5 154 595 59
Blood eosinophils Total IgE Total IgE
≥0.41x10^≥90/L.41x10.^396/[L0.27,00.3.466[]0.27, 0.4965][0.91,00.9.957[]0.91, 0.7997][0.65,00.7.898[]0.65,
0.8784][0.69,00.7.749[]0.69,
40.179] 1141
7211 2072 207
Table2.TDaiabgleno2s.tDiciagcncousrtaicyaoccfuthraecbyiofmtahrekberiosminatrhkercsoimnpthletceogmropulept(eng=r3o3u6p).(n=336). Table 2. Diagnostic accuracy of the biomarkers in the complete group (n=336).
FeNO
Blood eosiBnlopohdilesosinophils
≥64.5 ppb≥64.5 pp0b.39 [0.30,00.3.499[]0.30, 0.4995][0.92,00.9.958[]0.92, 0.8918][0.68,00.8.910[]0.68, 0.82 (0.77-0.87) ≥12.2 ppb 0.96 [0.90, 0.99] 0.28 [0.22, 0.34] 0.41 [0.35, 0.47] 0.83 (0.78-00.8.837()0.78-0≥.08.70)9x10^≥90/L.09x10.^996/[L0.90,00.9.969[]0.90, 0.2969][0.20,00.2.363[]0.20, 0.4303][0.34,00.4.406[]0.34,
0.9705][0.69,00.7.850[]0.69,
40.480] 1044
6910 20639 203 5 59
5 161 575 57 69 203
threshold
≥64.5 ppb 0.39 [0.30, 0.49] 0.95 [0.92, 0.98] 0.81 [0.68, 0.90]
0.75 [0.69, 0.80]
44 10
0.83 (0.78-0.87) ≥0.09x10^9/L 0.96 [0.90, 0.99] 0.26 [0.20, 0.33] 0.40 [0.34, 0.46] 0.69 (0.63-00.6.795()0.63-0≥.1735.)5 kU/L≥13.5 kU0/.9L6 [0.90,00.9.969[]0.90, 0.9298][0.22,00.2.384[]0.22, 0.4314][0.350, 0.4.417[]0.35,
0.92 [0.81, 0.97] 0.4972][0.82,00.9.927[]0.82,
108 161 10.1907] 151710
5 57
5 157 605 60
≥0.41x10^9/L 0.36 [0.27, 0.46] 0.95 [0.91, 0.97] 0.79 [0.65, 0.88] ≥763.5 kU/≥L763.5 k0U.0/8L [0.04,00.0.184[]0.04, 0.1945][0.92,00.9.958[]0.92, 0.4978][0.25,00.4.71[]0.25,
0.74 [0.69, 0.79] 0.7616][0.61,00.6.761[]0.61,
41 11 90.71] 109
72 207
10160 201706 207
Total IgE
FeNO+blooFedNeOos+ibnlopohdilesosinop0h.i8ls7 (0.83-00.8.971()0.83-0≥.09.10)95* ≥0.095*0.95 [0.90,00.9.959[]0.90, 0.939][0.32,00.3.496[]0.32, 0.456][0.39,00.4.52[]0.39,
≥0.70* FeNO+blood eosinophils 0.87 (0.83-0.91) ≥0.095*
≥0.70* 0.46 [0.36,00.4.566[]0.36, 0.5965][0.91,00.9.958[]0.91, 0.8948][0.71,00.8.941[]0.71, 0.95 [0.90, 0.99] 0.39 [0.32, 0.46] 0.45 [0.39, 0.52]
0.66 [0.61, 0.71] 0.9717][0.71,00.7.872[]0.71,
9 10 50.182] 1051
106 207
6010 20610 201
0.69 (0.63-0.75) ≥13.5 kU/L 0.96 [0.90, 0.99] 0.28 [0.22, 0.34] 0.41 [0.35, 0.47] ≥763.5 kU/L 0.08 [0.04, 0.14] 0.95 [0.92, 0.98] 0.47 [0.25, 0.71]
0.92 [0.82, 0.97] 0.5924][0.86,00.9.948[]0.86,
110 157 10.0968] 121906
5 60
5 129 825 82
≥0.70* Table3.TDaisbtlreib3u.tDioisntroibfumtaiornkeorftmhraerskheorltdhsraetsh9o5l%dssaetn9si5ti%vitsyenasnidtivsipteycaifnicditsypiencidficffietyreintdaifsftehrmenatpahstehnmotayphese.notypes.
FeNO, ppbFeNO, ppb 8se.6n-s1i5ti.v1ity8≥.69-51%5.1 Blood eosiBnlopohdileso, xs1in0o^p9h/iLls, x10^9/L0.06-0.0950.06-0.095
4sp8.e5c-i6fi9c.i5ty4≥89.5%-69.5
FeNO, ppb
8.6-15.1
0.34-0.73 0.34-0.73 48.5-69.5
Total IgE, kTUo/tLal IgE, kU/L Blood eosinophils, x10^9/L
8.5-25.5 8.5-25.5 0.06-0.095
389-2181 389-2181 0.34-0.73
FeNO+blooFedNeOos+ibnlopohdilesosinophils 0.086-0.1308.0*86-0.138* Total IgE, kU/L 8.5-25.5
0.656-0.750*.656-0.75* 389-2181
sensitivitys≥e9n5s%itivity ≥95% Range lower threshold,
specificitys≥p9e5c%ificity ≥95% Range upper threshold,
FeNO+blood eosinophils 0.086-0.138*
* All test c*omAlbl itneastioconms wbienraetilongstrwaenrsefolormg etrda;ntshfeosremveadl;utehsecsoerrveaslupeosndcotroreasnpoinnddivtioduaanl’isndividual’s
probabilityproofbsapbuitluitmy oefosspinuotupmhileiao,sainsodpehteiliram, iansedebteyrtmheinfeodrmbyultaheprfovrimdeudlainprFoivgiudredEi2n. Figure E2.
* All test combinations were log transformed; these values correspond to an individual’s
AUC, areaAuUndCe, arrtehaeucnudrveer;tFheNcOu,rvfrea;cFteioNnOo,ffreaxchtaiolendonfietrxihcaolxeiden;itFrNic,ofaxlisde;nFeNga, tfiavlese; negative;
probability of sputum eosinophilia, as determined by the formula provided in Figure E2. FP, false pFoPsi,tfivaels;eTpNo,stirtuiveen; eTgNa,ttirvuee; TnPe,gtartuiveep;oTsPit,itvreu.e positive.
AUC, area under the curve; FeNO, fraction of exhaled nitric oxide; FN, false negative; FP, false positive; TN, true negative; TP, true positive.
0.46 [0.36, 0.56] 0.95 [0.91, 0.98] 0.84 [0.71, 0.91]
Table 3. Distribution of marker thresholds at 95% sensitivity and specificity in different asthma phenotypes. Range lowRearnthgerelsohwoeldr,threshold,Range uppRearntghereusphpoeldr,threshold,
0.656-0.75*
0.92 [0.82, 0.97]
108 154
0.4962][0.81,00.9.927[]0.81,
10.0987] 16108
0.94 [0.86, 0.98] 0.77 [0.71, 0.82]
106 129 51 10
5 82 60 201
22 2