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FeNO (45, 50, 55, and 200\u00a0mL\/s), complete blood counts, sputum cytology, and spirometry were performed. Correlations between FeNOs and sputum\/peripheral eosinophils were analyzed. Receiver operating characteristic (ROC) curves assessed FeNOs' predictive value for identifying sputum eosinophilia, alone or in combination with peripheral eosinophils.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      FeNO at 50\u00a0mL\/s (FeNO50) exhibited the strongest correlation with peripheral eosinophils (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.51,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and was superior to FeNO45\/55 in predicting sputum eosinophilia (AUC\u2009=\u20090.694 for 2% eosinophilia, 0.726 for 3% eosinophilia;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). FeNO200 demonstrated better predictive accuracy (AUC\u2009=\u20090.717 at 2%, 0.743 at 3%), with cutoffs of 9.6\u00a0ppb (2%) and 10.5\u00a0ppb (3%). Combining FeNO200 with elevated peripheral eosinophil counts further improved diagnostic accuracy (AUC\u2009=\u20090.806 at 2%, 0.763 at 3%; peripheral eosinophil cutoffs: 155 and 275 cells\/\u03bcL, respectively). Moreover, FeNOs correlated more strongly with absolute sputum eosinophil counts compared to percentages. Asthmatics exhibiting both reduced small airway indices and FEV\n                      <jats:sub>1<\/jats:sub>\n                      presented significantly elevated FeNO levels.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Precisely controlling expiratory flow rate at 50\u00a0mL\/s improves the correlation between FeNO and eosinophil counts, while FeNO200 yields superior diagnostic performance. Combining FeNO200 with peripheral eosinophil counts offers a robust strategy for accurately detecting airway eosinophilic inflammation in asthma.<\/jats:p>\n                    <jats:p>\n                      <jats:italic>Clinical Trial Registration<\/jats:italic>\n                      <jats:bold>:<\/jats:bold>\n                      ChiCTR2500104677 (Date of Registration: 2025-06-20).\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s40001-026-04039-y","type":"journal-article","created":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T18:04:54Z","timestamp":1771524294000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Identifying optimal flow rates for airway eosinophilia detection in asthma"],"prefix":"10.1186","volume":"31","clinical-trial-number":[{"clinical-trial-number":"chictr2500104677","registry":"10.18810\/chictr"}],"author":[{"given":"Yiting","family":"Wu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yanmei","family":"Lin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huijuan","family":"Hao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jingwang","family":"Lin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yan","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yilin","family":"Pan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Min","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wuping","family":"Bao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,2,19]]},"reference":[{"key":"4039_CR1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pccm.2025.02.005","author":"Z Mao","year":"2025","unstructured":"Mao Z, Zhu X, Zheng P, et al. 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