FeNO Interpretation Note

Date/Time: [Date and time test performed]

Location: [Clinic or site]

Interpreting Clinician: [Name, credentials]

Indication & Context

Indication: [asthma diagnosis support (uncertain diagnosis) / asthma control and inflammation monitoring / controller therapy adjustment decision / adherence or response assessment / Indication not provided—interpreting in general context; clinical correlation required]

Context: [Age group: adult / pediatric]. [Current controller therapy if known]. [Relevant confounders: active smoking / vaping / allergic rhinitis / high allergen exposure / recent respiratory infection / none identified]. (Include only context items that are known and material to interpretation. If ICS exposure status is relevant but unknown, note: "Current ICS exposure unknown.")

Results

FeNO50: [Value] ppb ([Low / Intermediate / High]) (Use adult cut points: Low <25, Intermediate 25–50, High >50 ppb. Pediatric cut points: Low <20, Intermediate 20–35, High >35 ppb.)

[Prior FeNO: [value] ppb on [date]; change: [absolute change] ppb ([percent change]%). Clinically significant change threshold [met / not met].] (Include only if prior value exists. Significant change defined as >20% when baseline >50 ppb, or >10 ppb when baseline <50 ppb. Omit this line entirely if no prior result.)

[FeNO unable to be obtained. Reason: [reason]. Alternative assessment: [plan].] (Use only if acceptable maneuver could not be performed; omit FeNO50 line above.)

Interpretation

[Clinical interpretation of FeNO result in 2–4 sentences addressing likelihood of type 2/eosinophilic inflammation and expected steroid responsiveness based on result category, modified by relevant clinical context such as ICS exposure, smoking, allergen burden, or recent infection. Include correlation statement such as: "Interpretation should be integrated with symptoms, exacerbation history, and objective airflow measures."] (Do not diagnose asthma solely from FeNO; frame as supportive or not supportive of clinical suspicion. Do not assert nonadherence as fact based solely on FeNO; if suspected, document as a possibility and state how it will be evaluated.)

Plan

Problem: [Asthma—airway inflammation assessment / other relevant problem]

• Action: [No change in anti-inflammatory therapy / Start controller therapy / Step up therapy / Step down therapy / Adherence and technique intervention without dose change / Further evaluation needed before change]
• Rationale: [Brief statement linking FeNO interpretation to the action]
• Follow-up: [Reassessment timing and what will be evaluated] (Include when therapy is changed; typically 4–8 weeks.)
• [Limitations: [factors that may have affected test validity]] (Include only if pre-test conditions may have impacted accuracy; otherwise omit.)