@article {CollinsPA3124, author = {Samuel Collins and Laura Behan and Kerry Gove and Amanda-Lea Harris and Jane Lucas}, title = {Effective patient selection for PCD diagnostics; the PICADAR score with nasal nitric oxide}, volume = {48}, number = {suppl 60}, elocation-id = {PA3124}, year = {2016}, doi = {10.1183/13993003.congress-2016.PA3124}, publisher = {European Respiratory Society}, abstract = {Primary ciliary dyskinesia (PCD) symptoms are non-specific and tools to aid patient selection for referral are needed.Objectives: To assess accuracy of a validated symptom score (PICADAR) [Behan, ERJ, 2016], in combination with nasal nitric oxide (nNO) to identify patients needing full diagnostics.Methods: Prospective data from 142 consecutive referrals for PCD diagnostics (33 PCD positive, 111 negative). Sensitivity/specifity calculated using either PICADAR score \>5 or nNO below threshold (30, 77 or 100nl/min) as a positive test compared to final diagnosis of PCD.Results: PICADAR alone had sensitivity 0.88 and specificity 0.95. nNO+PICADAR improved identification of PCD positive patients. Accuracy was dependent on nNO threshold; sensitivities/specificities were 0.94/0.89, 0.94/0.78 and 1.0/0.73 using 30, 77 and 100nl/min.Accuracy of single test (nNO or PICADAR)Accuracy of simultaneous testing (nNO or PICADAR positive)nNO (30nl/min)nNo (77nl/min)nNo (100nl/min)PICADARnNO (30nl/min) + PICADARnNO (77nl/min) + PICADARnNO (100nl/min) + PICADARTrue pos30313329313133True neg1059181105998678False pos620306122533False neg3204220Sens.(95\% CI)0.91 (0.76-0.98)0.94 (0.80-0.99)1.00 (0.89-1.00)0.88 (0.72-0.97)0.94 (0.80-0.99)0.94 (0.80-0.99)1.00 (0.89-1.0)Spec.(95\% CI)0.95 (0.89-0.98)0.82 (0.74-0.89)0.73 (0.64-0.81)0.95 (0.89-0.98)0.89 (0.82-0.94)0.78 (0.69-0.85)0.70 (0.60-0.79)Accuracy of individual/combination testing using PICADAR and nasal nitric oxide (nNO)Conclusion: PICADAR effectively selects patients for referral to PCD diagnostics but some cases are missed. Addition of nNO provides a highly sensitive patient selection; 100nl/min nNO threshold gives a sensitivity and negative predictive value of 100\%.}, issn = {0903-1936}, URL = {https://erj.ersjournals.com/content/48/suppl_60/PA3124}, eprint = {https://erj.ersjournals.com/content}, journal = {European Respiratory Journal} }