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Various prescribing measures for asthma suggest suboptimal control (eg, excess prescribing of short-acting beta2 agonist inhalers) and it is reported that the diagnosis of asthma is incorrect in up to one-third of patients.1 There is, therefore, a strong case to be made for using objective tests before starting or escalating asthma treatment. Measurement of fractional exhaled nitric oxide (FeNO) has been proposed as a quick, easy to perform, noninvasive, diagnostic tool. Raised FeNO levels indicate eosinophil airway inflammation and support a diagnosis of asthma.2
The National Institute for Health and Care Excellence (NICE) published evidence-based recommendations on FeNO in 2014 and included FeNO measurement in its diagnostic algorithms for asthma in 2017.2 3 Currently, FeNO devices cost around £3000 and the cost of a test varies depending on the number carried out each year but is estimated at £10 per test. NICE suggests that the use of …
Competing interests None declared. Refer to the online supplementary files to view the ICMJE form(s).
Provenance and peer review Commissioned; externally peer reviewed.
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