Page 77 - ADULT-ONSET ASTHMA PREDICTORS OF CLINICAL COURSE AND SEVERITY

DIAGNOSTIC ACCURACY OF MINIMALLY INVASIVE MARKERS FOR DETECTION OF AIRWAY EOSINOPHILIA IN ASTHMA
Table 1: Overall diagnostic performance of markers for detecting any airway eosinophilia.
Studies in adults1
Studies in children1
Studies evaluating marker
N
AUCs Sum of AUC2 Included patients
N N Pooled (95%CI)
17 19 3216 14 14 2405 7 7 942 2 3 204 2 2 174 2 2 96 1 1 18 1 1 53 1 1 130
0.75 (0.72-0.78) 0.78 (0.74-0.82) 0.65 (0.61-0.69) 0.65 (0.49-0.81) 0.72 (0.64-0.81) 0.76 (0.63-0.90) 0.98*
0.69* 0.88*
Index test
FeNO
Blood eosinophils Serum IgE
Serum Periostin
Serum ECP
EBCpH
Exhaled VOCs
EBC model
Nasal lavage eosinophils
Studies evaluating marker
N
6
3
0 --- 0 --- 1 1 77 0.75* 0--- 0-- - 0-- - 0-- -
AUCs Sum of Included patients
N N
AUC2
Pooled (95%CI)
5 349 3 192
0.81 (0.72-0.89) 0.78 (0.71-0.85)
1Five different definitions of airway eosinophilia were used across studies, based on different thresholds for induced sputum, bronchoalveolar lavage and/or endobronchial biopsy.
2Results based on random effects meta-analysis. Detailed information on diagnostic accuracy data for individual studies can be found in Appendix 5.
*Meta-analysis not possible as only one study reported on AUC.
List of abbreviations: AUC: Area under the receiver operator curve; EBC: Exhaled Breath Condensate; ECP: Eosinophil Cationic Protein; FeNO: Fraction of exhaled Nitric Oxide; IgE: Immunoglobulin E; VOCs: Volatile Organic Compounds.
Table 2: Summary estimates of sensitivity and specificity for detecting sputum eosinophilia in adults. Sputum eosinophils ≥3% Sputum eosinophils ≥2%
Studies Patients Sensitivity Specificity N N (95%CI) (95%CI)
12 1720 12 1967 5 920 6 699
0.66 (0.57-0.75) 0.71 (0.65-0.76) 0.76 (0.52-0.90) 0.64 (0.42-0.81)
0.76 (0.65-0.85) 0.77 (0.70-0.83) 0.74 (0.67-0.80) 0.71 (0.42-0.89)
Index test
Studies N
Patients N 1667
Sensitivity (95%CI) 0.65 (0.55-0.74) 0.66 (0.56-0.75)
List of abbreviations: AUC: Area under the receiver operator curve; FeNO: Fraction of exhaled Nitric Oxide; IgE: Immunoglobulin E.
Specificity (95%CI) 0.75 (0.62-0.84) 0.83 (0.62-0.94)
FeNO 9
Blood eosinophils (in /μL) Blood eosinophils (in %) Serum IgE
6 1180
2 171 - -
4 754 0.63 (0.36-0.84) 0.59 (0.37-0.79)
1
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