117: Association Between Fraction of Exhaled Nitrous Oxide (FeNO), Parameters of Asthma Control and Inhaled Corticosteroid Type in a Regional Paediatric Asthma Center
Bibliographic record
Abstract
FeNO is a known marker of airway inflammation, and is a topic of recent investigation for asthma control in children. To investigate the relationship between FeNO and known parameters of asthma control in a regional paediatric asthma center. A secondary objective was to investigate the correlation between different types of inhaled corticosteroids (ICS) and FeNO concentration. We conducted a retrospective chart review of children tested with both spirometry and FeNO over a one-year period. Collected data included age, anthropometrics, ICS type, equivalent dose, and duration of use, recent oral steroid use, asthma severity score, season, smoking status of family, and the presence or absence of; eczema, allergic rhinitis and respiratory tract infection. Data was analyzed by descriptive statistics and stepwise linear regression. A univariate generalized linear model was built to evaluate FeNO by ICS type, while correcting for statistically significant covariates. A total of 183 children were included. Mean (± SD) age was 12.8±2.8 years. Fluticasone was used most commonly (n=66, 36.1%) followed by ciclesonide (n=50 [27.3%]). Most children had moderate-persistent asthma (n=73 [39.9%]). FeNO level was associated with percent-change in FEV1 while adjusting for allergic rhinitis, parental smoking and ICS type (B=0.08 [95% CI 0.04 to 0.12]; P<0.001). Likewise, FeNO was associated with percent-change in FEF 25–75 while adjusting for parental smoking and ICS type (B=0.13 [95% CI 0.01 to 0.24]; P=0.03). However, FeNO accounted for only 16% and 9% of the variability in FEV1 and FEF 25–75, respectively. FeNO level differed by ICS type, while adjusting for equivalent dosing, allergic rhinitis and weight. Mean adjusted FeNO was lowest in fluticasone users compared to no ICS (mean difference ppb = 18.3 (95% CI 4.5 to 32.1]) and there was no difference in adjusted FeNO level between ciclesonide and no ICS (6.1 [95% CI −5.9 to 18.2]). FeNO levels correlate with known parameters of asthma control in a regional pediatric asthma center. However, FeNO accounts for only 16% and 9% of the variability in FEV1 and FeF 25–75. Mean adjusted FeNO varied by ICS type suggesting there is a difference in relative efficacy between inhaled corticosteroids beyond their dose equivalents.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".