Is home monitoring of lung function worthwhile for children with asthma?

A Review of Portable Electronic Spirometers: Implications for Asthma Self-Management

PURPOSE OF REVIEW

Although portable electronic spirometers allow for at-home lung function monitoring, a comprehensive review of these devices has not yet been conducted. We conducted a systematic search and review of commercially available portable electronic spirometers designed for asthma patient use.

RECENT FINDINGS

All devices (N = 16) allowed for monitoring of basic lung function parameters, but only 31% provided in-app videos on how to perform breathing maneuvers. Most devices (63%) provided graphical representations of lung function results, but only 44% gave immediate feedback on the quality of the breathing maneuver. Several devices (25%) were FDA-approved and cost ranged from US$99 to $1390. Information on data security (63%), measurement accuracy (50%), and association with patient outcomes (0%) was commonly limited. This review found that providers' ability to make informed decisions about whether asthma patients may benefit from portable electronic spirometers is limited due to lack of patient outcome data.

Spirometry in the diagnosis of asthma in children

PURPOSE OF REVIEW

To review the diagnostic accuracy of lung function measurements made using spirometry for childhood asthma, recent guidelines for the measurement and interpretation of spirometric lung function tests and recent developments for diagnosing asthma.

RECENT FINDINGS

Measurements of lung function and bronchial lability made using spirometry may not perform any better than other tests such as skin prick testing, or measurements of exhaled nitric oxide for diagnosing asthma. New guidelines are available.

SUMMARY

Spirometry is a simple, robust and widely available tool for investigating lung function. There are published guidelines for making measurements and their interpretation. The place of spirometry in the diagnosis of asthma, however, needs clarification. The diagnostic profiles of measurements of bronchodilator responsiveness and bronchial hyperreactivity made using spirometry, although reasonable, are not perfect. In schoolchildren, they are no better than knowledge of aeroallergen sensitization when considering a diagnosis of asthma.