American Thoracic Society Quick-Reference GUIDELINES Apps
Issue link: https://eguideline.guidelinecentral.com/i/592884
2 Diagnosis Table 3. Diagnosis Context Recommendation Values and preferences Computed tomography of chest In children and adults with severe asthma without specific indications for chest high resolution computed tomography (HRCT) based on history, symptoms and/or results of prior investigations, the ATS and ERS suggest that a chest HRCT only be done when the presentation is atypical. (Conditional recommendation/ Very low quality of evidence) is recommendation places a relatively high value on identification of alternative diagnosis and comorbidities and a relatively low value on avoiding potential complications and cost of chest HRCT. Sputum eosinophil counts In adults with severe asthma, the ATS and ERS suggest treatment guided by clinical criteria and sputum eosinophil counts performed in centers experienced in using this technique rather than by clinical criteria alone. (Conditional recommendation/ Very low quality of evidence) e recommendation to use sputum eosinophil counts to guide therapy in adults places a higher value on possible clinical benefits from adjusting the treatment in selected patients and on avoidance of inappropriate escalation of treatment and a lower value on increased use of resources. In children with severe asthma, the ATS and ERS suggest treatment guided by clinical criteria alone rather than by clinical criteria and sputum eosinophil counts. (Conditional recommendation/ Very low quality of evidence) e recommendation not to use sputum eosinophil counts to guide therapy in children places higher value on avoiding an intervention that is not standardized and not widely available and lower value on the uncertain and possibly limited clinical benefit. Exhaled nitric oxide (FeNO) e ATS and ERS suggest that clinicians do NOT use FeNO to guide therapy in adults or children with severe asthma. (Conditional recommendation/ Very low quality of evidence) is recommendation places a higher value on avoiding additional resource expenditure and a lower value on uncertain benefit from monitoring FeNO.