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NICE Pathways bring together all NICE guidance, quality standards and other NICE
information on a specific topic.

NICE Pathways are interactive and designed to be used online. They are updated
regularly as new NICE guidance is published. To view the latest version of this pathway
see:

http://pathways.nice.org.uk/pathways/asthma
Pathway last updated: 03 October 2017

This document contains a single pathway diagram and uses numbering to link the
boxes to the associated recommendations.

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1 Person with suspected asthma

No additional information

2 Diagnosis and monitoring

NICE is developing a guideline on diagnosing and monitoring asthma (publication date to be


confirmed).

Fractional exhaled nitric oxide testing

The following recommendations are from NICE diagnostics guidance pm Measuring fractional
exhaled nitric oxide concentration in asthma: NIOX MINO, NIOX VERO and Nobreath.

Fractional exhaled nitric oxide (FeNO) testing is recommended as an option to help diagnose
asthma in adults and children:

who, after initial clinical examination, are considered to have an intermediate probability of
having asthma (as defined in the British guideline on the management of asthma 2012) and
when FeNO testing is intended to be done in combination with other diagnostic options
according to the British guideline on the management of asthma (2012).

Further investigation is recommended for people whose FeNO test result is negative because a
negative result does not exclude asthma.

See also NICE's recommendations on differentiating between COPD and asthma).

Quality standards

The following quality statements are relevant to this part of the interactive flowchart.

1. Diagnosis

2. Diagnosing occupational asthma

3. Written and personalised action plans

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3 Management

See Asthma / Asthma management

4 Review

NICE has published a quality statement on people with asthma receiving a structured review
(see below).

See NICE's recommendations on transition from children's to adults' services.

Quality standards

The following quality statement is relevant to this part of the interactive flowchart.

5. Review

5 See what NICE says on patient experience

See Patient experience

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Sources

Measuring fractional exhaled nitric oxide concentration in asthma: NIOX MINO, NIOX VERO
and Nobreath (2014) NICE diagnostics guidance 12

Your responsibility

The guidance in this pathway represents the view of NICE, which was arrived at after careful
consideration of the evidence available. Those working in the NHS, local authorities, the wider
public, voluntary and community sectors and the private sector should take it into account when
carrying out their professional, managerial or voluntary duties. Implementation of this guidance
is the responsibility of local commissioners and/or providers. Commissioners and providers are
reminded that it is their responsibility to implement the guidance, in their local context, in light of
their duties to avoid unlawful discrimination and to have regard to promoting equality of
opportunity. Nothing in this guidance should be interpreted in a way which would be inconsistent
with compliance with those duties.

Contact NICE

National Institute for Health and Care Excellence


Level 1A, City Tower
Piccadilly Plaza
Manchester
M1 4BT

www.nice.org.uk

nice@nice.org.uk

0845 003 7781

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