The dangers of widespread nitric oxide screening for primary ciliary dyskinesia

Thorax. 2016 Jun;71(6):560-1. doi: 10.1136/thoraxjnl-2015-208056. Epub 2016 Feb 19.


Primary ciliary dyskinesia (PCD) is underdiagnosed and requires complex testing at specialist diagnostic centres. Measurement of nasal nitric oxide (nNO) has good sensitivity and specificity screening for PCD, but is currently usually measured at PCD centres rather than prior to referral. Proposals to include NO testing for asthma diagnoses could widen access to PCD screening if nasal mode analysers are available. Data from 282 consecutive referrals to our PCD diagnostic centre (31 PCD positive) were used to model predictive values for nNO testing with varying pretest probability and showed that predictive values were good in the referral population, but extending screening to more general populations would result in excessive false positives that may overwhelm diagnostic services. Although nNO remains a useful test, a 'normal' result with classical clinical history should still be considered for further testing.

Keywords: Asthma; Exhaled Airway Markers; Rare lung diseases.

Publication types

  • Letter

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Breath Tests / methods*
  • Child
  • Diagnosis, Differential
  • Female
  • Humans
  • Kartagener Syndrome / diagnosis*
  • Male
  • Middle Aged
  • Nitric Oxide / analysis*
  • Predictive Value of Tests
  • Sensitivity and Specificity
  • United Kingdom


  • Nitric Oxide