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Talwar D, Balamurugan S, Modi M, Salvi S, Lopez M, Shah R, Vaidya A, Barne M, Madas S, Kulkarni N, Sawant S, Gogtay J. Comparison of a portable, pneumotach flow-sensor-based spirometer (Spirofy™) with the vitalograph alpha Touch™ spirometer in evaluating lung function in healthy individuals, asthmatics, and COPD patients-a randomized, crossover study. BMC Pulm Med 2024; 24:230. [PMID: 38730359 PMCID: PMC11088097 DOI: 10.1186/s12890-024-02972-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 03/18/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Spirofy™ is India's first portable, pneumotach flow-sensor-based digital spirometer developed to diagnose asthma and chronic obstructive pulmonary disease (COPD). In this study, we compared the performance of the Spirofy™ device with that of the Vitalograph Alpha Touch™ spirometer in measuring the lung capacities of healthy individuals, asthmatics, and COPD patients. We also assessed the inter-device variability between two Spirofy™ devices. METHODS In a randomized, three-way crossover, open-label study, we measured the differences in forced expiratory volume in the first second (FEV1) and forced vital capacity (FVC) between the Spirofy™ and Vitalograph Alpha Touch™ spirometers. A proportion of the FEV1/FVC ratio distribution of < 0.7 was used to compare the diagnostic accuracies of the Spirofy™ with Vitalograph™ Alpha Touch™ spirometers. RESULTS Ninety subjects participated in this study. The mean ± SD FVC values obtained from the Spirofy™ 1, Spirofy™ 2, and Vitalograph Alpha Touch™ devices were 2.60 ± 1.05 L, 2.64 ± 1.04 L, and 2.67 ± 1.04 L, respectively. The mean ± SD FEV1 values obtained from the Spirofy™ 1, Spirofy™ 2, and Vitalograph Alpha Touch™ devices were 1.87 ± 0.92 (L), 1.88 ± 0.92 (L), and 1.93 ± 0.93 (L), respectively. A significant positive correlation was found between the FVC and FEV1 values recorded by Vitalograph Alpha Touch™, Spirofy™ 1, and Spirofy™ 2. As compared to Vitalograph Alpha Touch™, the Spirofy™ device showed good sensitivity (97%), specificity (90%), and overall accuracy (93.3%) at an FEV1/FVC ratio < 0.7. No inter-device variability was observed between the two Spirofy™ devices. CONCLUSION Spirofy™ is a portable and easy-to-use device and is as accurate as the standard Vitalograph Alpha Touch™ spirometer for the diagnosis of COPD and asthma. TRIAL REGISTRATION CTRI/2021/09/036492 (Clinical Trials Registry - India).
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Affiliation(s)
- Deepak Talwar
- Department of Pulmonology, Pulmonary Sleep & Critical Care, Metro Centre for Respiratory Diseases, WASOG Sarcoid Clinic, Noida, Uttar Pradesh, India
| | - S Balamurugan
- Department of Pulmonology, Chest & Diabetes Research Institute, Chennai, Tamil Nadu, India
| | - Mahavir Modi
- Department of Pulmonology, Ruby Hall Clinic, Pune, Mumbai, Maharashtra, India
| | - Sundeep Salvi
- Pulmocare Research & Education Foundation (PURE), Pune, Maharashtra, India
| | - Meena Lopez
- Department of Medical Affairs, Cipla Ltd, Mumbai, Maharashtra, India.
| | - Rushika Shah
- Department of Medical Affairs, Cipla Ltd, Mumbai, Maharashtra, India
| | - Abhijit Vaidya
- Department of Medical Affairs, Cipla Ltd, Mumbai, Maharashtra, India
| | - Monica Barne
- Training Research Programs, Chest Research & Training Pvt Ltd, Pune, Maharashtra, India
| | - Sapna Madas
- Department of Data Management & Statistics, Chest Research & Training Pvt Ltd, Pune, Maharashtra, India
| | | | - Sandesh Sawant
- Department of Medical Affairs, Cipla Ltd, Mumbai, Maharashtra, India
| | - Jaideep Gogtay
- Department of Medical Affairs, Cipla Ltd, Mumbai, Maharashtra, India
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Szylling A, Raciborski F, Wojas O, Furmańczyk K, Krzych‐Fałta E, Bousquet J, Samoliński B. Why the role of mHealth in allergy diagnosis and treatment adherence cannot be overlooked. Clin Transl Allergy 2023; 13:e12298. [PMID: 37876036 PMCID: PMC10580813 DOI: 10.1002/clt2.12298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 08/16/2023] [Accepted: 08/20/2023] [Indexed: 10/26/2023] Open
Abstract
BACKGROUND Allergic diseases-rhinitis and asthma-are the most common chronic conditions affecting adults. Traditional approaches to allergy diagnosis and treatment do not meet the health needs of all patients. Treatment adherence remains a challenge for physicians. The ubiquity of Internet access paired with limited in-person contact with medical personnel in the course of the COVID-19 pandemic demonstrated the potential of mHealth in communicating health information. BODY: The abundance of new applications dedicated to various medical specialties encourages reflection on the informed use of such tools. The paper takes a closer look at the potential of mHealth and presents conclusions of selected studies focusing on the use of good apps. The strength weakness opportunities threats analysis was used to illustrate the strengths of the mHealth strategy, as well as its advantages, limitations and areas in need of further development. CONCLUSION The strength of mHealth depends on the quality and quantity of the collected patient data, its reliable processing, as well as publication of outcomes and conclusions from analyses. Therefore, it is necessary to promote the use of validated applications among patients, physicians and medical staff.
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Affiliation(s)
- Anna Szylling
- Department of Allergy and Clinical ImmunologyUniversity Clinical Center of the Medical University of Warsaw Central Clinical HospitalWarszawaMazowieckiePoland
| | - Filip Raciborski
- Department of Prevention of Environmental Hazards, Allergology and ImmunologyMedical University of WarsawWarszawaMazowieckiePoland
| | - Oksana Wojas
- Department of Prevention of Environmental Hazards, Allergology and ImmunologyMedical University of WarsawWarszawaMazowieckiePoland
| | - Konrad Furmańczyk
- Department of Prevention of Environmental Hazards, Allergology and ImmunologyMedical University of WarsawWarszawaMazowieckiePoland
- Institute of Information TechnologyWarsaw University of Life SciencesWarszawaPoland
| | | | - Jean Bousquet
- Institute of AllergologyCharite Universitatsmedizin BerlinBerlinGermany
- University of MontpellierMontpellierFrance
| | - Boleslaw Samoliński
- Department of Allergy and Clinical ImmunologyUniversity Clinical Center of the Medical University of Warsaw Central Clinical HospitalWarszawaMazowieckiePoland
- Department of Prevention of Environmental Hazards, Allergology and ImmunologyMedical University of WarsawWarszawaMazowieckiePoland
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Li Y, Huang K, Li W, Peng Y, Tang X, Yang T. Validation of a new portable system containing both FeNO analysis and spirometry measurement. Front Med (Lausanne) 2023; 10:1210329. [PMID: 37720515 PMCID: PMC10501136 DOI: 10.3389/fmed.2023.1210329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Accepted: 08/14/2023] [Indexed: 09/19/2023] Open
Abstract
Introduction Pulmonary function tests and FeNO measurements are widely used for the diagnosis and management of respiratory diseases. They are used to evaluate airway limitation and respiratory inflammation. Standard spirometers and nitric oxide (NO) analyzers are widely used in hospitals. However, their high price has made some hospitals in underdeveloped areas unable to afford or purchase these devices. The development of a new portable system (SUNVOU TM2125) combining FeNO measurement and spirometry provides additional possibilities for optimizing the diagnosis and management of respiratory diseases. However, its accuracy needs further validation. Methods The FeNO analysis component of SUNVOU TM2125 was compared with that of a widely used NO analyzer (NIOX VERO). The spirometry component of the TM2125 was compared with a standard spirometer (Jaeger MasterScreen) for pulmonary parameters such as FEV1, FVC, FEV1/FVC, and PEF. Pearson correlation and Bland-Altman plots were used to evaluate the agreement between the devices. Results FeNO values measured using TM2125 were higher than those measured using VERO, with a mean difference of 1.8 ppb. There was a strong correlation between FeNO values measured using the two devices (r = 0.988, p < 0.001). Bland-Altman plots showed a high degree of agreement between the two devices, with 93.3% of values within the 95% confidence interval range. The spirometric parameters (FEV1, FVC, FEV1/FVC, and PEF) measured using the TM2125 were lower than those measured using the MasterScreen. Good correlations were observed between the values measured using the TM2125 and MasterScreen (r > 0.9). Based on the Bland-Altman plots, there was a high degree of agreement between the devices. Conclusion The accuracy of FeNO and spirometry measurements using SUNVOU TM2125 was validated. This can help improve the diagnosis and monitoring of chronic respiratory diseases in underdeveloped countries.
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Affiliation(s)
- Yong Li
- National Center for Respiratory Diseases, State Key Laboratory of Respiratory Health and Multimorbidity, National Clinical Research Center for Respiratory Diseases, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospitall, Beijing, China
| | - Ke Huang
- National Center for Respiratory Diseases, State Key Laboratory of Respiratory Health and Multimorbidity, National Clinical Research Center for Respiratory Diseases, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospitall, Beijing, China
| | - Wei Li
- National Center for Respiratory Diseases, State Key Laboratory of Respiratory Health and Multimorbidity, National Clinical Research Center for Respiratory Diseases, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospitall, Beijing, China
| | - Yaodie Peng
- Peking University China-Japan Friendship School of Clinical Medicine, Beijing, China
| | | | - Ting Yang
- National Center for Respiratory Diseases, State Key Laboratory of Respiratory Health and Multimorbidity, National Clinical Research Center for Respiratory Diseases, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospitall, Beijing, China
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Blanco-Aparicio M, Almonacid C, Calvín Lamas M, Delgado J, Gandolfo-Cano M, López-Carrasco V, Vega JM, Díaz-Pérez D, Villamañán E. [Telemedicine and severe asthma in our environment: Views on the experience of professionals and suggestions to make it a reality]. OPEN RESPIRATORY ARCHIVES 2023; 5:100239. [PMID: 37810420 PMCID: PMC10556775 DOI: 10.1016/j.opresp.2023.100239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 03/02/2023] [Indexed: 03/19/2023] Open
Abstract
This paper aims to examine the recent experience in telemedicine (TM) management of patients with severe asthma (SA). A committee of health professionals involved in asthma management (pulmonology, allergology, respiratory nursing, and hospital pharmacy) held discussion meetings on the practical experience of TM for the management of SA and the means available complemented with a bibliographic search to know the current status of TM in SA. The main barriers detected for the implementation of TM in SA have been the lack of technological training, the lack of registration of TM in the clinical history, the care overload, or the connectivity problems at the administration level. The practical solutions are provided such as the selection of the patient suitable for TM, the registration of TM in the medical record, its inclusion in the care objectives or the increase of funding for systems. Moreover, the main App and Webapp for use by patients are provided, and the portable equipment for remote functional respiratory tests. In conclusion, it is necessary that the teleconsultation has the same entity as the face-to-face visit with a schedule in the appointment's agenda and a structure of both the medical interview and the tests to be performed in each consultation. Additionally, should be promoted the implementation of a video call system, tools that allow the monitoring of both therapeutic adherence and inhalation technique, as well as the patient's lung function.
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Affiliation(s)
| | - Carlos Almonacid
- Servicio de Neumología, Hospital Universitario de Toledo, Toledo, España
| | - Marta Calvín Lamas
- Servicio de Farmacia, Complexo Hospitalario Universitario A Coruña, A Coruña, España
| | - Julio Delgado
- Unidad de Gestión Clínica Alergología, Hospital Virgen Macarena, Sevilla, España
| | - Mar Gandolfo-Cano
- Servicio de Alergología, Hospital Universitario de Fuenlabrada, Madrid, España
| | | | - José María Vega
- Servicio de Alergología, Hospital Regional Universitario de Málaga, Málaga, España
| | - David Díaz-Pérez
- Servicio de Neumología, Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, España
| | - Elena Villamañán
- Servicio de Farmacia, Hospital Universitario La Paz, Madrid, España
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Siddiqui S, Haf Davies E, Afshar M, Denlinger LC. Clinical Trial Design Innovations for Precision Medicine in Asthma. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1426:395-412. [PMID: 37464130 DOI: 10.1007/978-3-031-32259-4_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Abstract
Severe asthma is a spectrum disorder with numerous subsets, many of which are defined by clinical history and a general predisposition for T2 inflammation. Most of the approved therapies for severe asthma have required clinical trial designs with population enrichment for exacerbation frequency and/or elevation of blood eosinophils. Moving beyond this framework will require trial designs that increase efficiency for studying nondominant subsets and continue to improve upon biomarker signatures. In addition to reviewing the current literature on biomarker-informed trials for severe asthma, this chapter will also review the advantages of master protocols and adaptive design methods for establishing the efficacy of new interventions in prospectively defined subsets of patients. The incorporation of methods that allow for data collection outside of traditional study visits at academic centers, called remote decentralized trial design, is a growing trend that may increase diversity in study participation and allow for enhanced resiliency during the COVID-19 pandemic. Finally, reaching the goals of precision medicine in asthma will require increased emphasis on effectiveness studies. Recent advances in real-world data utilization from electronic health records are also discussed with a view toward pragmatic trial designs that could also incorporate the evaluation of biomarker signatures.
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Affiliation(s)
- Salman Siddiqui
- National Heart and Lung Institute, Imperial College, London, England, UK
| | | | - Majid Afshar
- Division of Allergy, Pulmonary and Critical Care, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Loren C Denlinger
- Division of Allergy, Pulmonary and Critical Care, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
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Teleallergy: Where Have We Been and Where Are We Going? THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2023; 11:126-131. [PMID: 36064184 DOI: 10.1016/j.jaip.2022.08.032] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 08/25/2022] [Accepted: 08/25/2022] [Indexed: 01/11/2023]
Abstract
Telemedicine uptake in allergy/immunology was slow before the coronavirus disease 2019 pandemic, but has accelerated since. This review examines where telemedicine has been in allergy/immunology and where it is headed in the future. Focus is placed on patient, physician, and health care professional satisfaction with telemedicine, capacity to expand access to allergy/immunology care, cost considerations, the regulatory environment, and future applications of telemedicine including adherence monitoring, wearable biosensors, artificial intelligence, and machine learning addressed.
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Initiating home spirometry for children during the COVID-19 pandemic - A practical guide. Paediatr Respir Rev 2022; 42:43-48. [PMID: 33773928 PMCID: PMC7893248 DOI: 10.1016/j.prrv.2021.02.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 02/11/2021] [Indexed: 12/14/2022]
Abstract
The COVID-19 pandemic has led to a rapid escalation in use of home monitoring and video consultations in children with a variety of chronic respiratory conditions. Our department set up a home spirometry service from scratch once it became evident that we needed to keep patients away from hospital clinics whenever possible. We faced a number of challenges but now have around 400 children using home spirometers. There are a number of portable spirometers available, some with online platforms. The technology, particularly the software/apps interface, has been improved by the companies in response to issues that have arisen. We believe the use of home monitoring is here to stay.
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Sekerel BE, Unsal H, Sahiner UM, Uysal Soyer O, Damadoglu E, Karakaya G, Kalyoncu AF. Clinical Validation of the Spirohome Clinic Ultrasonic Spirometer in Child and Adolescent Patients. J Asthma Allergy 2022; 15:219-229. [PMID: 35210788 PMCID: PMC8859473 DOI: 10.2147/jaa.s345189] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 01/05/2022] [Indexed: 11/23/2022] Open
Abstract
Background Spirometers are critical devices that reveal the respiratory dynamics caused by respiratory problems and their severity and facilitate their diagnosis and follow-up. Hand-held spirometers have emerged relatively recently and offer several advantages over conventional desktop systems. There remains, however, a need for reassurance of high-quality spirometry testing with next-generation portable spirometers that connect over Bluetooth® to smart device applications. In this study, we examine the accuracy and repeatability of lung function measurements of a novel hand-held ultrasonic spirometer, the Spirohome Clinic and compare its clinical performance to a reference device, the EasyOne Air. Methods Benchtop validation of the spirometers was conducted using a lung simulator device according to ATS/ERS guidelines and the ISO 26782 standard waveforms. Subsequently, 48 volunteers (pediatric patients between 6 and 11 years of age and adolescent patients between 12 and 18 years of age) performed spirometry with both the Spirohome Clinic and the EasyOne Air spirometer during their clinic visits. Spirometric data including repeated FEV1, FVC, FEV6, FEF25-75, and PEF measurements were collected. Results Both the Spirohome Clinic and the EasyOne Air successfully passed requirements for accuracy stated in relevant guidelines and standards for spirometry. The only statistically significant (p<0.05) difference was for FVC measurement accuracy. Clinical comparisons revealed strong correlation between spirometers in the measurement of key pulmonary function parameters including FEV1 and FVC with a Pearson's correlation coefficient of 0.99. Bland–Altman plots showed good agreement between mean differences of FEV1 and FVC with the majority measurements remaining between the limits of 95% agreement for both the entire patient cohort and also in age and gender subsets. Conclusion The present study demonstrated that the Spirohome Clinic spirometer conforms to ATS/ERS performance requirements and validates the clinical comparability of its measurement accuracy and repeatability to the EasyOne Air. These findings support the indicated use of the Spirohome Clinic for high-quality lung function testing in clinical settings.
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Affiliation(s)
- Bulent Enis Sekerel
- Division Pediatric Allergy and Asthma, Hacettepe University Faculty of Medicine, Ankara, Turkey
- Correspondence: Bulent Enis Sekerel, Tel +90 312 305 17 00, Fax +90 312 305 50 00, Email
| | - Hilal Unsal
- Division Pediatric Allergy and Asthma, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Umit Murat Sahiner
- Division Pediatric Allergy and Asthma, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Ozge Uysal Soyer
- Division Pediatric Allergy and Asthma, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Ebru Damadoglu
- Division of Allergy and Immunology, Department of Chest Diseases, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Gul Karakaya
- Division of Allergy and Immunology, Department of Chest Diseases, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Ali Fuat Kalyoncu
- Division of Allergy and Immunology, Department of Chest Diseases, Hacettepe University Faculty of Medicine, Ankara, Turkey
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Alvarez-Perea A, Dimov V, Popescu FD, Zubeldia JM. The applications of eHealth technologies in the management of asthma and allergic diseases. Clin Transl Allergy 2021; 11:e12061. [PMID: 34504682 PMCID: PMC8420996 DOI: 10.1002/clt2.12061] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 08/20/2021] [Accepted: 08/25/2021] [Indexed: 01/14/2023] Open
Abstract
Portable devices, such as smartphones and mobile Internet access have become ubiquitous in the last decades. The term 'eHealth' stands for electronic health. The tools included in the eHealth concept utilize phones, computers and the Internet and related applications to improve the health care industry. Implementation of eHealth technologies has been documented for the management of different chronic diseases, including asthma and allergic conditions. Clinicians and patients have gained opportunity to communicate in new ways, which could be used cost-effectively to improve disease control and quality of life of those affected. Additionally, these innovations bring new opportunities to academic researchers. For example, eHealth has allowed researchers to compile data points that were previously unavailable or difficult to access, and analyse them using novel tools, collectively described as 'big data'. The role of eHealth become more important since early 2020, due to the physical distancing rules and the restrictions on mobility that have been applied worldwide as a response to the coronavirus disease 2019 pandemic. In this review, we summarize the most recent developments in various eHealth platforms and their relevance to the speciality of allergy and immunology, from the point of view of three major stakeholders: clinicians, patients and researchers.
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Affiliation(s)
- Alberto Alvarez-Perea
- Allergy Service Hospital General Universitario Gregorio Marañón Madrid Spain.,Gregorio Marañón Health Research Institute Madrid Spain
| | - Ves Dimov
- Cleveland Clinic Florida FAU Charles E. Schmidt College of Medicine Weston Florida USA
| | - Florin-Dan Popescu
- Department of Allergology 'Nicolae Malaxa' Clinical Hospital 'Carol Davila' University of Medicine and Pharmacy Bucharest Romania
| | - José Manuel Zubeldia
- Allergy Service Hospital General Universitario Gregorio Marañón Madrid Spain.,Gregorio Marañón Health Research Institute Madrid Spain.,Biomedical Research Network on Rare Diseases (CIBERER)-U761 Madrid Spain
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Lin CH, Cheng SL, Wang HC, Hsu WH, Lee KY, Perng DW, Lin HI, Lin MS, Tsai JR, Wang CC, Lin SH, Wang CY, Chen CZ, Yang TM, Liu CL, Wang TY, Lin MC. Novel App-Based Portable Spirometer for the Early Detection of COPD. Diagnostics (Basel) 2021; 11:785. [PMID: 33925463 PMCID: PMC8146797 DOI: 10.3390/diagnostics11050785] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 04/21/2021] [Accepted: 04/21/2021] [Indexed: 11/16/2022] Open
Abstract
Chronic obstructive pulmonary disease (COPD) is preventable and treatable. However, many patients remain undiagnosed and untreated due to the underutilization or unavailability of spirometers. Accordingly, we used Spirobank Smart, an app-based spirometer, for facilitating the early detection of COPD in outpatient clinics. This prospective study recruited individuals who were at risk of COPD (i.e., with age of ≥40 years, ≥10 pack-years of smoking, and at least one respiratory symptoms) but had no previous COPD diagnosis. Eligible participants were examined with Spirobank Smart and then underwent confirmatory spirometry (performed using a diagnostic spirometer), regardless of their Spirobank Smart test results. COPD was defined and confirmed using the postbronchodilator forced expiratory volume in 1 s/forced vital capacity values of <0.70 as measured by confirmatory spirometry. A total of 767 participants were enrolled and examined using Spirobank Smart; 370 participants (94.3% men, mean age of 60.9 years and mean 42.6 pack-years of smoking) underwent confirmatory spirometry. Confirmatory spirometry identified COPD in 103 participants (27.8%). At the optimal cutoff point of 0.74 that was determined using Spirobank Smart for COPD diagnosis, the area under the receiver operating characteristic was 0.903 (95% confidence interval (CI) = 0.860-0.947). Multivariate logistic regression revealed that participants who have an FEV1/FVC ratio of <74% that was determined using Spirobank Smart (odds ratio (OR) = 58.58, 95% CI = 27.29-125.75) and old age (OR = 3.23, 95% CI = 1.04-10.07 for 60 ≤ age < 65; OR = 5.82, 95% CI = 2.22-15.27 for age ≥ 65) had a higher risk of COPD. The Spirobank Smart is a simple and adequate tool for early COPD detection in outpatient clinics. Early diagnosis and appropriate therapy based on GOLD guidelines can positively influence respiratory symptoms and quality of life.
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Affiliation(s)
- Ching-Hsiung Lin
- Division of Chest Medicine, Changhua Christian Hospital, Changhua 500, Taiwan; (C.-H.L.); (S.-H.L.)
- Institute of Genomics and Bioinformatics, National Chung Hsing University, Taichung 402, Taiwan
- Department of Recreation and Holistic Wellness, MingDao University, Changhua 523, Taiwan
| | - Shih-Lung Cheng
- Department of Internal Medicine, Far Eastern Memorial Hospital, Taipei 220, Taiwan
- Department of Chemical Engineering and Materials Science, Yuan Ze University, Zhongli, Taoyuan 320, Taiwan
| | - Hao-Chien Wang
- Department of Internal Medicine, National Taiwan University Hospital, Taipei 100, Taiwan;
| | - Wu-Huei Hsu
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung 404, Taiwan;
| | - Kang-Yun Lee
- Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City 110, Taiwan;
| | - Diahn-Warng Perng
- Department of Chest Medicine, Taipei Veterans General Hospital, Taipei 112, Taiwan; (D.-W.P.); (C.-Y.W.)
| | - Hen-I. Lin
- Department of Internal Medicine, Cardinal Tien Hospital, Fu-Jen Catholic University, Taipei 242, Taiwan;
| | - Ming-Shian Lin
- Department of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi 600, Taiwan;
| | - Jong-Rung Tsai
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan;
| | - Chin-Chou Wang
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 833, Taiwan;
| | - Sheng-Hao Lin
- Division of Chest Medicine, Changhua Christian Hospital, Changhua 500, Taiwan; (C.-H.L.); (S.-H.L.)
| | - Cheng-Yi Wang
- Department of Chest Medicine, Taipei Veterans General Hospital, Taipei 112, Taiwan; (D.-W.P.); (C.-Y.W.)
| | - Chiung-Zuei Chen
- Division of Pulmonary Medicine, Department of Internal Medicine, National Cheng Kung University, College of Medicine and Hospital, Tainan 701, Taiwan;
| | - Tsung-Ming Yang
- Department of Pulmonary and Critical Care Medicine, Chang Gung Memorial Hospital, Chiayi Branch 613, Taiwan;
| | - Ching-Lung Liu
- Division of Chest Medicine, Department of Internal Medicine, MacKay Memorial Hospital, Taipei 104, Taiwan;
| | - Tsai-Yu Wang
- Department of Thoracic Medicine, Chang Gung Memorial Hospital at Linkou, Chang Gung University, College of Medicine, Taipei 333, Taiwan;
| | - Meng-Chih Lin
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 833, Taiwan;
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Kouri A, Gupta S, Yadollahi A, Ryan CM, Gershon AS, To T, Tarlo SM, Goldstein RS, Chapman KR, Chow CW. Addressing Reduced Laboratory-Based Pulmonary Function Testing During a Pandemic. Chest 2020; 158:2502-2510. [PMID: 32652095 PMCID: PMC7345485 DOI: 10.1016/j.chest.2020.06.065] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 06/23/2020] [Accepted: 06/27/2020] [Indexed: 01/04/2023] Open
Abstract
To reduce the spread of the severe acute respiratory syndrome coronavirus 2, many pulmonary function testing (PFT) laboratories have been closed or have significantly reduced their testing capacity. Because these mitigation strategies may be necessary for the next 6 to 18 months to prevent recurrent peaks in disease prevalence, fewer objective measurements of lung function will alter the diagnosis and care of patients with chronic respiratory diseases. PFT, which includes spirometry, lung volume, and diffusion capacity measurement, is essential to the diagnosis and management of patients with asthma, COPD, and other chronic lung conditions. Both traditional and innovative alternatives to conventional testing must now be explored. These may include peak expiratory flow devices, electronic portable spirometers, portable exhaled nitric oxide measurement, airwave oscillometry devices, and novel digital health tools such as smartphone microphone spirometers and mobile health technologies along with integration of machine learning approaches. The adoption of some novel approaches may not merely replace but could improve existing management strategies and alter common diagnostic paradigms. With these options comes important technical, privacy, ethical, financial, and medicolegal barriers that must be addressed. However, the coronavirus disease 19 pandemic also presents a unique opportunity to augment conventional testing by including innovative and emerging approaches to measuring lung function remotely in patients with respiratory disease. The benefits of such an approach have the potential to enhance respiratory care and empower patient self-management well beyond the current global pandemic.
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Affiliation(s)
- Andrew Kouri
- Division of Respirology, Department of Medicine, St. Michael's Hospital, Unity Health Toronto, Toronto, ON.
| | - Samir Gupta
- Division of Respirology, Department of Medicine, St. Michael's Hospital, Unity Health Toronto, Toronto, ON,Department of Medicine, University of Toronto, Toronto, ON
| | - Azadeh Yadollahi
- Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, ON,KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, ON
| | - Clodagh M. Ryan
- Department of Medicine, University of Toronto, Toronto, ON,Division of Respirology, Department of Medicine, Toronto General Hospital, University Health Network, Toronto, ON
| | - Andrea S. Gershon
- Department of Medicine, University of Toronto, Toronto, ON,Division of Respirology, Department of Medicine, Sunnybrook Health Sciences Center, Toronto, ON
| | - Teresa To
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, ON,Dalla Lana Graduate School of Public Health, University of Toronto, Toronto, ON
| | - Susan M. Tarlo
- Department of Medicine, University of Toronto, Toronto, ON,Division of Respirology, Department of Medicine, Toronto Western Hospital, University Health Network, Toronto, ON
| | - Roger S. Goldstein
- Department of Medicine, University of Toronto, Toronto, ON,Division of Respiratory Medicine, West Part Healthcare Centre, Toronto, ON, Canada
| | - Kenneth R. Chapman
- Department of Medicine, University of Toronto, Toronto, ON,Division of Respirology, Department of Medicine, Toronto Western Hospital, University Health Network, Toronto, ON
| | - Chung-Wai Chow
- Department of Medicine, University of Toronto, Toronto, ON,Division of Respirology, Department of Medicine, Toronto General Hospital, University Health Network, Toronto, ON
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12
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Studnicka M, Baumgartner B, Bolitschek J, Doberer D, Eber E, Eckmayr J, Hartl S, Hesse P, Jaksch P, Kink E, Kneussl M, Lamprecht B, Olschewski H, Pfleger A, Pohl W, Prior C, Puelacher C, Renner A, Steflitsch W, Stelzmüller I, Täubl H, Vonbank K, Wagner M, Wantke F, Wass R. [Masterplan 2025 of the Austrian Society of Pneumology (ASP)-the expected burden and management of respiratory diseases in Austria]. Wien Klin Wochenschr 2020; 132:89-113. [PMID: 32990821 DOI: 10.1007/s00508-020-01722-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Scientific Members of the Austrian Society of Pneumology describe the expected development in respiratory health and provide guidance towards patient-oriented and cost-efficient respiratory care in Austria.Methods: In November 2017, respiratory care providers (physicians, nurses, physiotherapists) together with patient's advocacy groups and experts in health development, collaborated in workshops on: respiratory health and the environment, bronchial asthma and allergy, COPD, pediatric respiratory disease, respiratory infections, sleep disorders, interventional pneumology, thoracic oncology and orphan diseases.Results: Respiratory disease is extremely prevalent and driven by ill-health behavior, i.e. cigarette smoking, over-eating and physical inactivity. For the majority of respiratory diseases increased prevalence, but decreased hospitalizations are expected.The following measures should be implemented to deal with future challenges:1. Screening and case-finding should be implemented for lung cancer and COPD.2. E-health solutions (telemedicine, personal apps) should be used to facilitate patient management.3. Regional differences in respiratory care should be reduced through E‑health and harmonization of health insurance benefits across Austria.4. Patient education and awareness, to reduce respiratory health illiteracy should be increased, which is essential for sleep disorders but relevant also for other respiratory diseases.5. Respiratory care should be inter-professional, provided via disease-specific boards beyond lung cancer (for ILDs, sleep, allergy)6. Programs for outpatient's pulmonary rehabilitation can have a major impact on respiratory health.7. Increased understanding of molecular pathways will drive personalized medicine, targeted therapy (for asthma, lung cancer) and subsequently health care costs.
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Affiliation(s)
- Michael Studnicka
- Landeskrankenhaus Salzburg, Universitätsklinik für Pneumologie/Lungenheilkunde, Müllner Hauptstraße 48, 5020, Salzburg, Österreich. .,Paracelsus Medical University, Salzburg, Österreich.
| | - Bernhard Baumgartner
- Abteilung für Pulmologie, Salzkammergut-Klinikum Vöcklabruck, Vöcklabruck, Österreich
| | - Josef Bolitschek
- Abteilung für Pneumologie, Ordensklinikum Linz GmbH Elisabethinen, Linz, Österreich
| | - Daniel Doberer
- Klin. Abteilung für Pulmologie, Medizinische Universität Wien, Wien, Österreich
| | - Ernst Eber
- Univ.-Klinik für Kinder- und Jugendheilkunde, Medizinische Universität Graz, Graz, Österreich
| | - Josef Eckmayr
- Abteilung für Lungenkrankheiten, Klinikum Wels-Grieskirchen, Wels, Österreich
| | - Sylvia Hartl
- 2. Interne Lungenabteilung, Otto Wagner-Spital, Wien, Österreich
| | - Peter Hesse
- Ordination Dr. Judith & Dr. Peter Hesse, Schwechat, Österreich
| | - Peter Jaksch
- Klin. Abteilung für Thoraxchirurgie, Medizinische Universität Wien, Wien, Österreich
| | - Eveline Kink
- Lungenabteilung, LKH Graz II - Standort Enzenbach, Gratwein-Straßengel, Österreich
| | - Meinhard Kneussl
- ehem. 2. Medizinische Abteilung mit Pneumologie, Wilhelminenspital Wien, Wien, Österreich
| | - Bernd Lamprecht
- Klinik für Lungenheilkunde, Kepler Universitätsklinikum, Linz, Österreich
| | - Horst Olschewski
- Klinische Abteilung für Pulmonologie, LKH-Univ. Klinikum Graz, Graz, Österreich
| | - Andreas Pfleger
- Univ.-Klinik für Kinder- und Jugendheilkunde, Medizinische Universität Graz, Graz, Österreich
| | - Wolfgang Pohl
- Abteilung für Atmungs- und Lungenerkrankungen, Krankenhaus Hietzing, Wien, Österreich
| | - Christian Prior
- Ordination Univ.-Prof. Dr. Christian Prior, Innsbruck, Österreich
| | | | - Andreas Renner
- Abteilung für Atmungs- und Lungenerkrankungen, Krankenhaus Hietzing, Wien, Österreich
| | - Wolfgang Steflitsch
- Wahlarzt-Ordination für Lungenheilkunde, Ollersbach bei Neulengbach, Österreich
| | | | - Helmut Täubl
- Standort Natters, Pulmologie, LKH Hochzirl-Natters, Natters, Österreich
| | - Karin Vonbank
- Klin. Abteilung für Pulmologie, Medizinische Universität Wien, Wien, Österreich
| | - Marlies Wagner
- Univ.-Klinik für Kinder- und Jugendheilkunde, Medizinische Universität Graz, Graz, Österreich
| | - Felix Wantke
- FAZ Floridsdorfer Allergiezentrum GmbH, Wien, Österreich
| | - Romana Wass
- Klinik für Lungenheilkunde, Kepler Universitätsklinikum, Linz, Österreich
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