Nasal potential difference measurements in diagnosis of cystic fibrosis: an international survey

J Cyst Fibros. 2014 Jan;13(1):24-8. doi: 10.1016/j.jcf.2013.08.006. Epub 2013 Sep 7.

Abstract

Background: The role of nasal potential difference (NPD) measurement as a diagnostic test for cystic fibrosis (CF) is a subject of global controversy because of the lack of validation studies, clear reference values, and standardized protocols for diagnostic NPD.

Methods: To determine diagnostic NPD frequency, protocols, interpretation, and rater agreement, we surveyed the 18 NPD centres of the European Cystic Fibrosis Society Diagnostic Network Working Group.

Results: Fifteen centres reported performing 373 diagnostic NPDs in 2012. Most use the CFF-TDN-SOP (67%) and the chloride-free + isoproterenol response of the side with the largest response (47%) as diagnostic criteria and use centre-specific reference ranges. Rater agreement for five NPD tracings - in general - was good, but poor in tracings with different responses between the two nostrils.

Conclusions: NPD is frequently used as a diagnostic and research tool for CF. Performance is highly standardized, centre-specific reference ranges are established, and rater agreement - in general - is good. Centre-independent diagnostic criteria and reference ranges must be defined by multicentre validation studies to improve standardized interpretation for diagnostic use.

Keywords: Cystic fibrosis; Diagnosis; Nasal potential difference.

Publication types

  • Multicenter Study
  • Validation Study

MeSH terms

  • Adrenergic beta-Agonists
  • Amiloride
  • Chlorides / metabolism
  • Cystic Fibrosis / diagnosis*
  • Cystic Fibrosis / metabolism
  • Diagnostic Techniques, Respiratory System / standards*
  • Diagnostic Techniques, Respiratory System / statistics & numerical data
  • Electrodiagnosis / methods
  • Electrodiagnosis / standards*
  • Electrodiagnosis / statistics & numerical data
  • Epithelial Sodium Channel Blockers
  • Europe
  • Health Care Surveys*
  • Humans
  • Internationality
  • Isoproterenol
  • Membrane Potentials
  • Nasal Mucosa / metabolism*
  • Observer Variation
  • Reference Values
  • Reproducibility of Results
  • Surveys and Questionnaires

Substances

  • Adrenergic beta-Agonists
  • Chlorides
  • Epithelial Sodium Channel Blockers
  • Amiloride
  • Isoproterenol