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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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Lessof C, Cooper R, Wong A, Bendayan R, Caleyachetty R, Cheshire H, Cosco T, Elhakeem A, Hansell AL, Kaushal A, Kuh D, Martin D, Minelli C, Muthuri S, Popham M, Shaheen SO, Sturgis P, Hardy R. Comparison of devices used to measure blood pressure, grip strength and lung function: A randomised cross-over study. PLoS One 2023; 18:e0289052. [PMID: 38150442 PMCID: PMC10752545 DOI: 10.1371/journal.pone.0289052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 07/11/2023] [Indexed: 12/29/2023] Open
Abstract
BACKGROUND Blood pressure, grip strength and lung function are frequently assessed in longitudinal population studies, but the measurement devices used differ between studies and within studies over time. We aimed to compare measurements ascertained from different commonly used devices. METHODS We used a randomised cross-over study. Participants were 118 men and women aged 45-74 years whose blood pressure, grip strength and lung function were assessed using two sphygmomanometers (Omron 705-CP and Omron HEM-907), four handheld dynamometers (Jamar Hydraulic, Jamar Plus+ Digital, Nottingham Electronic and Smedley) and two spirometers (Micro Medical Plus turbine and ndd Easy on-PC ultrasonic flow-sensor) with multiple measurements taken on each device. Mean differences between pairs of devices were estimated along with limits of agreement from Bland-Altman plots. Sensitivity analyses were carried out using alternative exclusion criteria and summary measures, and using multilevel models to estimate mean differences. RESULTS The mean difference between sphygmomanometers was 3.9mmHg for systolic blood pressure (95% Confidence Interval (CI):2.5,5.2) and 1.4mmHg for diastolic blood pressure (95% CI:0.3,2.4), with the Omron HEM-907 measuring higher. For maximum grip strength, the mean difference when either one of the electronic dynamometers was compared with either the hydraulic or spring-gauge device was 4-5kg, with the electronic devices measuring higher. The differences were small when comparing the two electronic devices (difference = 0.3kg, 95% CI:-0.9,1.4), and when comparing the hydraulic and spring-gauge devices (difference = 0.2kg, 95% CI:-0.8,1.3). In all cases limits of agreement were wide. The mean difference in FEV1 between spirometers was close to zero (95% CI:-0.03,0.03), limits of agreement were reasonably narrow, but a difference of 0.47l was observed for FVC (95% CI:0.53,0.42), with the ndd Easy on-PC measuring higher. CONCLUSION Our study highlights potentially important differences in measurement of key functions when different devices are used. These differences need to be considered when interpreting results from modelling intra-individual changes in function and when carrying out cross-study comparisons, and sensitivity analyses using correction factors may be helpful.
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Affiliation(s)
- Carli Lessof
- National Centre for Research Methods, University of Southampton, Southampton, United Kingdom
| | - Rachel Cooper
- Faculty of Medical Sciences, Translational and Clinical Research Institute, AGE Research Group, Newcastle University, Newcastle upon Tyne, United Kingdom
- NIHR Newcastle Biomedical Research Centre, Newcastle University and Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Andrew Wong
- MRC Unit for Lifelong Health and Ageing at UCL, London, United Kingdom
| | - Rebecca Bendayan
- Department of Biostatistics and Health Informatics of the Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
- NIHR Biomedical Research Centre at South London and Maudsley, NHS Foundation Trust and King’s College London, London, United Kingdom
| | - Rishi Caleyachetty
- Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
- Warwick Medical School, University of Warwick, Warwick, United Kingdom
| | | | - Theodore Cosco
- Department of Gerontology, Simon Fraser University, Vancouver, Canada and Oxford Institute of Population Ageing, University of Oxford, Oxford, United Kingdom
| | - Ahmed Elhakeem
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, United Kingdom
| | - Anna L. Hansell
- Centre for Environmental Health and Sustainability, University of Leicester, United Kingdom
| | - Aradhna Kaushal
- Research Department of Behavioural Science and Health, UCL, London, United Kingdom
| | - Diana Kuh
- MRC Unit for Lifelong Health and Ageing at UCL, London, United Kingdom
| | - David Martin
- National Centre for Research Methods, University of Southampton, Southampton, United Kingdom
| | - Cosetta Minelli
- National Heart & Lung Institute, Imperial College London, United Kingdom
| | - Stella Muthuri
- MRC Unit for Lifelong Health and Ageing at UCL, London, United Kingdom
| | - Maria Popham
- MRC Unit for Lifelong Health and Ageing at UCL, London, United Kingdom
| | - Seif O. Shaheen
- Institute of Population Health Sciences, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Patrick Sturgis
- Department of Methodology, London School of Economics, United Kingdom
| | - Rebecca Hardy
- Social Research Institute, UCL, London, United Kingdom
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom
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Berresheim H, Beine A, van Kampen V, Lehnert M, Nöllenheidt C, Brüning T, Hoffmeyer F. ATS/ ERS spirometry quality criteria in real life. Results of two occupational field studies. Respir Physiol Neurobiol 2023:104094. [PMID: 37391004 DOI: 10.1016/j.resp.2023.104094] [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: 04/13/2023] [Revised: 06/05/2023] [Accepted: 06/15/2023] [Indexed: 07/02/2023]
Abstract
Spirometry is a widely used test and the American Thoracic Society and the European Respiratory Society (ATS/ERS) provide standardised recommendations. However, detailed information on test quality is often incomplete in publications. In light of the 2005 ATS/ERS recommendations, we investigated the acceptability and repeatability criteria of spirometry performed under occupational field conditions in 242 practicing welders (WELDOX study, median age 41.5 years, all male) and 312 first-year veterinary students (AllergoVet study, median age 20.0 years, 84.3% female). At least three acceptable or usable measurements could be identified for 233 welders and 305 students. The repeatability for welders was 96.1% for the forced expiratory volume in the first second (FEV1) and 97.0% for forced vital capacity (FVC). The corresponding results for students were 95.7% and 95.4%, respectively. The overall repeatability of test sessions at the 150-mL level was 90.5% (219/242) for welders and 90.1% (281/312) for students. Spirometry can be performed with reliable quality in an occupational field setting.
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Affiliation(s)
- Hans Berresheim
- Institute for Prevention and Occupational Medicine of the German Social Accident, 44789 Bochum, Germany; Insurance, Institute of the Ruhr-Universität Bochum (IPA), Bürkle-de-la-Camp-Platz 1, 44789 Bochum, Germany
| | - Alexandra Beine
- Institute for Prevention and Occupational Medicine of the German Social Accident, 44789 Bochum, Germany; Insurance, Institute of the Ruhr-Universität Bochum (IPA), Bürkle-de-la-Camp-Platz 1, 44789 Bochum, Germany
| | - Vera van Kampen
- Institute for Prevention and Occupational Medicine of the German Social Accident, 44789 Bochum, Germany; Insurance, Institute of the Ruhr-Universität Bochum (IPA), Bürkle-de-la-Camp-Platz 1, 44789 Bochum, Germany
| | - Martin Lehnert
- Institute for Prevention and Occupational Medicine of the German Social Accident, 44789 Bochum, Germany; Insurance, Institute of the Ruhr-Universität Bochum (IPA), Bürkle-de-la-Camp-Platz 1, 44789 Bochum, Germany
| | - Christoph Nöllenheidt
- Institute for Prevention and Occupational Medicine of the German Social Accident, 44789 Bochum, Germany; Insurance, Institute of the Ruhr-Universität Bochum (IPA), Bürkle-de-la-Camp-Platz 1, 44789 Bochum, Germany
| | - Thomas Brüning
- Institute for Prevention and Occupational Medicine of the German Social Accident, 44789 Bochum, Germany; Insurance, Institute of the Ruhr-Universität Bochum (IPA), Bürkle-de-la-Camp-Platz 1, 44789 Bochum, Germany
| | - Frank Hoffmeyer
- Institute for Prevention and Occupational Medicine of the German Social Accident, 44789 Bochum, Germany; Insurance, Institute of the Ruhr-Universität Bochum (IPA), Bürkle-de-la-Camp-Platz 1, 44789 Bochum, Germany.
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Nafisi VR, Eghbal M, Torbati N. Conceptual Design of a Device for Online Calibration of Spirometer Based on Neural Network. J Biomed Phys Eng 2023; 13:291-296. [PMID: 37312895 PMCID: PMC10258211 DOI: 10.31661/jbpe.v0i0.1038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Accepted: 01/22/2021] [Indexed: 06/15/2023]
Abstract
Daily calibration of spirometry devices plays an important role in promoting the accuracy of pulmonary diagnostic results. It is needed to have more precise and adequate instruments for calibrating spirometry during the clinical use. In this work, a device was designed and developed based on a calibrated-volume syringe and an electrical circuit was also built to measure the air flux. Some colored tapes with specific size and order covered the syringe piston. When the piston moved in front of the color sensor, the input air flow was calculated according to the width of the strips and transferred to the computer. A Radial Basis Function (RBF) neural network estimator used new data to modify the previous estimation function for increasing the accuracy and the reliability. The simulation showed that the root mean square of the error improved from 13.7±0.37% to 4.2±0.22%, i.e. the calibration curve has improved about 70%.
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Affiliation(s)
- Vahid Reza Nafisi
- Biomedical Engineering group, Department of Electrical & Information Technology, Iranian Research Organization for Science and Technology, Tehran, Iran
| | - Manouchehr Eghbal
- Biomedical Engineering group, Department of Electrical & Information Technology, Iranian Research Organization for Science and Technology, Tehran, Iran
| | - Nasim Torbati
- Food and Drug Administration, Ministry of Health and Medical Education, Tehran, Iran
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García Castillo E, Alonso Pérez T, Peláez A, Pérez González P, Miravitlles M, Alfageme I, Casanova C, Cosío BG, de Lucas P, García-Río F, Rodríguez González-Moro JM, Soler-Cataluña JJ, Sánchez G, Soriano JB, Ancochea J. Trends of COPD in Spain: Changes Between Cross Sectional Surveys 1997, 2007 and 2017. Arch Bronconeumol 2023; 59:142-151. [PMID: 36549937 DOI: 10.1016/j.arbres.2022.11.014] [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: 10/17/2022] [Revised: 11/22/2022] [Accepted: 11/23/2022] [Indexed: 12/12/2022]
Abstract
INTRODUCTION We aim to describe the changes in prevalence and risk factors associated to chronic obstructive pulmonary disease (COPD) in Spain, comparing three population-based studies conducted in three timepoints. METHODS We compared participants from IBERPOC conducted in 1997, EPISCAN conducted in 2007 and EPISCAN II in 2017. COPD was defined as a postbronchodilator FEV1/FVC (forced expiratory volume in 1s/forced vital capacity) ratio <0.70, according to GOLD criteria; subsequently, also as the FEV1/FVC below the lower limit of normal (LLN). RESULTS COPD prevalence in the population between 40 and 69 years decreased from 21.6% (95% CI 20.7%-23.2%) in 1997 to 8.8% (95% CI 8.2%-9.5%) in 2017, a 59.2% decline (p<0.001). In 2007, the prevalence was 7.7% (95% CI 6.8%-8.7%) with an upward trend of 1.1 percentage points in 2017 (p=0.073). Overall COPD prevalence decreased in men and women, although a significant increase was observed in the last decade in females (p<0.05). Current smokers significantly increased in the last decades (25.4% in 1997, 29.1% in 2007 and 23.4% in 2017; p<0.001). Regrettably, COPD underdiagnosis was constantly high, 77.6% in 1997, 78.4% in 2007, and to 78.2% in 2017 (p=0.95), higher in younger ages (40-49 yrs and 50-59 yrs) and also higher in women than in men in all three studies (p<0.05). CONCLUSIONS We report a significant reduction of 59.2% in the prevalence of COPD in Spain from 1997 to 2017 in subjects aged 40-69 years. Our study highlights the significant underdiagnosis of COPD, particularly sustained in women and younger populations.
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Affiliation(s)
- Elena García Castillo
- Pulmonary Department, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria La Princesa, Madrid, Spain; School of Medicine, Universidad Autónoma de Madrid (UAM), Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain.
| | - Tamara Alonso Pérez
- Pulmonary Department, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria La Princesa, Madrid, Spain; School of Medicine, Universidad Autónoma de Madrid (UAM), Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - Adrián Peláez
- Pulmonary Department, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria La Princesa, Madrid, Spain; School of Medicine, Universidad Autónoma de Madrid (UAM), Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - Patricia Pérez González
- Pulmonary Department, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria La Princesa, Madrid, Spain; School of Medicine, Universidad Autónoma de Madrid (UAM), Spain
| | - Marc Miravitlles
- Pulmonary Department, Hospital Universitari Vall d'Hebron-CIBERES, Barcelona, Spain
| | - Inmaculada Alfageme
- Unidad de Gestión Clínica de Neumología, Hospital Universitario Virgen de Valme, Departamento de Medicina, Universidad de Sevilla, Sevilla, Spain
| | - Ciro Casanova
- Pulmonary Department-Research Unit, Hospital Universitario Nuestra Señora de Candelaria, CIBERES, ISCIII, Universidad de La Laguna, Tenerife, Spain
| | - Borja G Cosío
- Pulmonary Department, Hospital Universitario Son Espases-IdISBa-Ciberes, Palma de Mallorca, Baleares, Spain
| | - Pilar de Lucas
- Pulmonary Department, Hospital General Gregorio Marañón, Madrid, Spain
| | - Francisco García-Río
- Pulmonary Department, Hospital Universitario La Paz-IdiPAZ-CIBERES, Madrid, Spain
| | | | - Juan José Soler-Cataluña
- Pulmonary Department, Hospital Arnau de Vilanova-Lliria, Universitat de València, Valencia, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | | | - Joan B Soriano
- Pulmonary Department, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria La Princesa, Madrid, Spain; School of Medicine, Universidad Autónoma de Madrid (UAM), Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - Julio Ancochea
- Pulmonary Department, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria La Princesa, Madrid, Spain; School of Medicine, Universidad Autónoma de Madrid (UAM), Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
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Vinod VG. "Study on factors associated with post bronchodilator reversibility among patients presenting with dyspnea". Lung India 2023; 40:97. [PMID: 36695272 PMCID: PMC9894268 DOI: 10.4103/lungindia.lungindia_372_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Accepted: 09/22/2022] [Indexed: 01/01/2023] Open
Affiliation(s)
- VG Vinod
- Department of Pulmonary Medicine, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India E-mail:
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Mgbemena N, Jones A, Saxena P, Ang N, Senthuran S, Leicht A. Acute changes in handgrip strength, lung function and health-related quality of life following cardiac surgery. PLoS One 2022; 17:e0263683. [PMID: 35196327 PMCID: PMC8865673 DOI: 10.1371/journal.pone.0263683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 01/24/2022] [Indexed: 11/18/2022] Open
Abstract
Background Handgrip strength (HGS), lung function and health-related quality of life (HRQoL) are relevant indicators of future cardiovascular risk and mortality. The impact of cardiac surgery on these predictive variables has been under-explored. The aim of this study was to determine the acute (within hospital) changes in HGS, lung function and HRQoL, and their relationships, in adults undergoing elective cardiac surgery. Further, the study examined the relationship between these variables and the predictors for lung function and HRQoL in these patients. Methods The study was a prospective cohort study that involved 101 patients who completed pre-operative (1–2 days before surgery) and physiotherapy discharge (5–7 days after surgery) assessments. Handgrip strength, lung function and HRQoL were assessed using JAMAR dynamometers, Vitalograph-Alpha or EasyOne spirometer, and Short-Form 36 questionnaire, respectively. Changes in these variables and their relationships were analysed using paired t-test and Pearson correlation coefficients, respectively. Prediction of lung function and HRQoL using HGS and other co-variates was conducted using regression analysis. Results At the time of physiotherapy discharge, lung function, HGS and the physical component of HRQoL were significantly (<0.001) reduced compared to their pre-operative values. Significant (<0.001) and moderate correlations were identified between HGS and lung function at pre-operation and physiotherapy discharge. Handgrip strength was a significant predictor of lung function pre-operatively but not at physiotherapy discharge. Pre-operative lung function and HRQoL, as well as other variables, were significant predictors of lung function and HRQoL during physiotherapy discharge. Conclusions Undergoing cardiac surgery acutely and significantly reduced lung function, HGS and physical component of HRQoL in adults with cardiac disease. Assessment of HGS at physiotherapy discharge may be a poor indicator of operative changes in lung function and HRQoL. Clinicians may consider HGS as an inadequate tool in predicting lung function and HRQoL following cardiac surgery.
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Affiliation(s)
- Nnamdi Mgbemena
- Department of Physiotherapy, James Cook University, Townsville, Queensland, Australia
- Australian Institute of Tropical Health & Medicine, James Cook University, Townsville, Queensland, Australia
- * E-mail:
| | - Anne Jones
- Department of Physiotherapy, James Cook University, Townsville, Queensland, Australia
- Australian Institute of Tropical Health & Medicine, James Cook University, Townsville, Queensland, Australia
| | - Pankaj Saxena
- Department of Cardiothoracic Surgery, Townsville University Hospital, Townsville, Queensland, Australia
- Department of Surgery, James Cook University, Townsville, Queensland, Australia
| | - Nicholas Ang
- Department of Cardiothoracic Surgery, Townsville University Hospital, Townsville, Queensland, Australia
| | - Siva Senthuran
- Department of Intensive Care Medicine, Townsville University Hospital, Townsville, Queensland, Australia
| | - Anthony Leicht
- Australian Institute of Tropical Health & Medicine, James Cook University, Townsville, Queensland, Australia
- Department of Sports and Exercise Science, James Cook University, Townsville, Queensland, Australia
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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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Duong M, Rangarajan S, Zaman M, Nasir NM, Seron P, Yeates K, Yusufali AM, Khatib R, Tse LA, Wang C, Wielgosz A, Teo K, Kumar R, Avezum A, Ismail R, çalık BT, Gopakumar S, Rahman O, Zatońska K, Rosengren A, Otero J, Kelishadi R, Diaz R, Puoane T, Yusuf S. Differences and agreement between two portable hand-held spirometers across diverse community-based populations in the Prospective Urban Rural Epidemiology (PURE) study. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000141. [PMID: 36962310 PMCID: PMC10021326 DOI: 10.1371/journal.pgph.0000141] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 12/03/2021] [Indexed: 05/19/2023]
Abstract
INTRODUCTION Portable spirometers are commonly used in longitudinal epidemiological studies to measure and track the forced expiratory volume in first second (FEV1) and forced vital capacity (FVC). During the course of the study, it may be necessary to replace spirometers with a different model. This raise questions regarding the comparability of measurements from different devices. We examined the correlation, mean differences and agreement between two different spirometers, across diverse populations and different participant characteristics. METHODS From June 2015 to Jan 2018, a total of 4,603 adults were enrolled from 628 communities in 18 countries and 7 regions of the world. Each participant performed concurrent measurements from the MicroGP and EasyOne spirometer. Measurements were compared by the intra-class correlation coefficient (ICC) and Bland-Altman method. RESULTS Approximately 65% of the participants achieved clinically acceptable quality measurements. Overall correlations between paired FEV1 (ICC 0.88 [95% CI 0.87, 0.88]) and FVC (ICC 0.84 [0.83, 0.85]) were high. Mean differences between paired FEV1 (-0.038 L [-0.053, -0.023]) and FVC (0.033 L [0.012, 0.054]) were small. The 95% limits of agreement were wide but unbiased (FEV1 984, -1060; FVC 1460, -1394). Similar findings were observed across regions. The source of variation between spirometers was mainly at the participant level. Older age, higher body mass index, tobacco smoking and known COPD/asthma did not adversely impact on the inter-device variability. Furthermore, there were small and acceptable mean differences between paired FEV1 and FVC z-scores using the Global Lung Initiative normative values, suggesting minimal impact on lung function interpretation. CONCLUSIONS In this multicenter, diverse community-based cohort study, measurements from two portable spirometers provided good correlation, small and unbiased differences between measurements. These data support their interchangeable use across diverse populations to provide accurate trends in serial lung function measurements in epidemiological studies.
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Affiliation(s)
- MyLinh Duong
- Department of Medicine, Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
- * E-mail:
| | - Sumathy Rangarajan
- Department of Medicine, Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Michele Zaman
- Department of Medicine, Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Nafiza Mat Nasir
- Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh Campus, Selangor, Malaysia
| | - Pamela Seron
- Facultad de Medicina, Universidad de La Frontera, Temuco, Chile
| | - Karen Yeates
- Pamoja Tunaweza Research Centre, Moshi, Tanzania
| | | | - Rasha Khatib
- Advocate Aurora Research Institute, Milwaukee, IL, United States of America
| | - Lap Ah Tse
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong
| | - Chuangshi Wang
- Medical Research & Biometrics Center, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical, Beijing, China
| | - Andreas Wielgosz
- University of Ottawa Department of Medicine, Ottawa, Ontario, Canada
| | - Koon Teo
- Department of Medicine, Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Rajesh Kumar
- State Health System Resource Center, Punjab, India
| | - Alvaro Avezum
- International Research Center, Hospital Alemão Oswaldo Cruz, São Paulo, SP, Brazil
| | - Rosnah Ismail
- Community Health Department, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Burcu Tumerdem çalık
- Faculty of Health Sciences, Department of Health Management, Marmara University, Istanbul, Turkey
| | - Soumya Gopakumar
- Health Action by People and Government Medical College, Thiruvananthapuram, Kerala, India
| | - Omar Rahman
- University of Liberal Arts Bangladesh, Dhaka, Bangladesh
| | | | | | - Johanna Otero
- Instituto Masira, Universidad de Santander (UDES), Bucaramanga, Colombia
| | - Roya Kelishadi
- Cardiovascular Research Institute, Chamran Hospital, Isfahan, Iran
| | - Rafael Diaz
- Estudios Clinicos Latinoamerica ECLA Rosario, Santa Fe, Argentina
| | - Thandi Puoane
- University of the Western Cape, School of Public Health, Cape Town, South Africa
| | - Salim Yusuf
- Department of Medicine, Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
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10
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Yu Z, Koppelman GH, Hoek G, Kerckhoffs J, Vonk JM, Vermeulen R, Gehring U. Ultrafine particles, particle components and lung function at age 16 years: The PIAMA birth cohort study. ENVIRONMENT INTERNATIONAL 2021; 157:106792. [PMID: 34388675 DOI: 10.1016/j.envint.2021.106792] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 07/12/2021] [Accepted: 07/21/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Particulate matter (PM) air pollution exposure has been linked to lung function in adolescents, but little is known about the relevance of specific PM components and ultrafine particles (UFP). OBJECTIVES To investigate the associations of long-term exposure to PM elemental composition and UFP with lung function at age 16 years. METHODS For 706 participants of a prospective Dutch birth cohort, we assessed associations of forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) at age 16 with average exposure to eight elemental components (copper, iron, potassium, nickel, sulfur, silicon, vanadium and zinc) in PM2.5 and PM10, as well as UFP during the preceding years (age 13-16 years) estimated by land-use regression models. After assessing associations for each pollutant individually using linear regression models with adjustment for potential confounders, independence of associations with different pollutants was assessed in two-pollutant models with PM mass and NO2, for which associations with lung function have been reported previously. RESULTS We observed that for most PM elemental components higher exposure was associated with lower FEV1, especially PM10 sulfur [e.g. adjusted difference -2.23% (95% confidence interval (CI) -3.70 to -0.74%) per interquartile range (IQR) increase in PM10 sulfur]. The association with PM10 sulfur remained after adjusting for PM10 mass. Negative associations of exposure to UFP with both FEV1 and FVC were observed [-1.06% (95% CI: -2.08 to -0.03%) and -0.65% (95% CI: -1.53 to 0.23%), respectively per IQR increase in UFP], but did not persist in two-pollutant models with NO2 or PM2.5. CONCLUSIONS Long-term exposure to sulfur in PM10 may result in lower FEV1 at age 16. There is no evidence for an independent effect of UFP exposure.
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Affiliation(s)
- Zhebin Yu
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands; Department of Epidemiology and Health Statistics, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Gerard H Koppelman
- Department of Pediatric Pulmonology, Beatrix Children's Hospital, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands; Groningen Research Institute for Asthma and COPD, University of Groningen, Groningen, the Netherlands
| | - Gerard Hoek
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
| | - Jules Kerckhoffs
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
| | - Judith M Vonk
- Groningen Research Institute for Asthma and COPD, University of Groningen, Groningen, the Netherlands; Department of Epidemiology, University Medical Center Groningen, University of Groningen, the Netherlands
| | - Roel Vermeulen
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Ulrike Gehring
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands.
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11
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Allinson JP, Afzal S, Çolak Y, Jarvis D, Backman H, van den Berge M, Boezen HM, Breyer MK, Breyer-Kohansal R, Brusselle G, Burghuber OC, Faner R, Hartl S, Lahousse L, Langhammer A, Lundbäck B, Nwaru BI, Rönmark E, Vikjord SAA, Vonk JM, Wijnant SRA, Lange P, Nordestgaard BG, Olvera N, Agusti A, Donaldson GC, Wedzicha JA, Vestbo J, Vanfleteren LEGW. Changes in lung function in European adults born between 1884 and 1996 and implications for the diagnosis of lung disease: a cross-sectional analysis of ten population-based studies. THE LANCET RESPIRATORY MEDICINE 2021; 10:83-94. [PMID: 34619103 DOI: 10.1016/s2213-2600(21)00313-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 06/10/2021] [Accepted: 06/22/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND During the past century, socioeconomic and scientific advances have resulted in changes in the health and physique of European populations. Accompanying improvements in lung function, if unrecognised, could result in the misclassification of lung function measurements and misdiagnosis of lung diseases. We therefore investigated changes in population lung function with birth year across the past century, accounting for increasing population height, and examined how such changes might influence the interpretation of lung function measurements. METHODS In our analyses of cross-sectional data from ten European population-based studies, we included individuals aged 20-94 years who were born between 1884 and 1996, regardless of previous respiratory diagnoses or symptoms. FEV1, forced vital capacity (FVC), height, weight, and smoking behaviour were measured between 1965 and 2016. We used meta-regression to investigate how FEV1 and FVC (adjusting for age, study, height, sex, smoking status, smoking pack-years, and weight) and the FEV1/FVC ratio (adjusting for age, study, sex, and smoking status) changed with birth year. Using estimates from these models, we graphically explored how mean lung function values would be expected to progressively deviate from predicted values. To substantiate our findings, we used linear regression to investigate how the FEV1 and FVC values predicted by 32 reference equations published between 1961 and 2015 changed with estimated birth year. FINDINGS Across the ten included studies, we included 243 465 European participants (mean age 51·4 years, 95% CI 51·4-51·5) in our analysis, of whom 136 275 (56·0%) were female and 107 190 (44·0%) were male. After full adjustment, FEV1 increased by 4·8 mL/birth year (95% CI 2·6-7·0; p<0·0001) and FVC increased by 8·8 mL/birth year (5·7-12·0; p<0·0001). Birth year-related increases in the FEV1 and FVC values predicted by published reference equations corroborated these findings. This height-independent increase in FEV1 and FVC across the last century will have caused mean population values to progressively exceed previously predicted values. However, the population mean adjusted FEV1/FVC ratio decreased by 0·11 per 100 birth years (95% CI 0·09-0·14; p<0·0001). INTERPRETATION If current diagnostic criteria remain unchanged, the identified shifts in European values will allow the easier fulfilment of diagnostic criteria for lung diseases such as chronic obstructive pulmonary disease, but the systematic underestimation of lung disease severity. FUNDING The European Respiratory Society, AstraZeneca, Chiesi Farmaceutici, GlaxoSmithKline, Menarini, and Sanofi-Genzyme.
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Affiliation(s)
- James P Allinson
- Department of Respiratory Medicine, Royal Brompton Hospital, London, UK; National Heart and Lung Institute, Imperial College London, London, UK.
| | - Shoaib Afzal
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark; Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Yunus Çolak
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark; Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark; Department of Internal Medicine, Section of Respiratory Medicine, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Debbie Jarvis
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Helena Backman
- Department of Public Health and Clinical Medicine, The OLIN Unit, Section of Sustainable Health, Umeå University, Umeå, Sweden
| | - Maarten van den Berge
- Department of Pulmonary Diseases, University of Groningen, University Medical Center Groningen, Groningen, Netherlands; Groningen Research Institute for Asthma and COPD, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - H Marike Boezen
- Groningen Research Institute for Asthma and COPD, University of Groningen, University Medical Center Groningen, Groningen, Netherlands; Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Marie-Kathrin Breyer
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria; Department of Respiratory and Critical Care Medicine, Clinic Penzing, Vienna, Austria
| | - Robab Breyer-Kohansal
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria; Department of Respiratory and Critical Care Medicine, Clinic Penzing, Vienna, Austria
| | - Guy Brusselle
- Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium; Department of Epidemiology, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands; Department of Respiratory Medicine, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands
| | - Otto C Burghuber
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria; Faculty of Medicine, Sigmund Freud University, Vienna, Austria
| | - Rosa Faner
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain; Centro de Investigación Biomedica en Red Enfermedades Respiratorias, Barcelona, Spain
| | - Sylvia Hartl
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria; Department of Respiratory and Critical Care Medicine, Clinic Penzing, Vienna, Austria; Faculty of Medicine, Sigmund Freud University, Vienna, Austria
| | - Lies Lahousse
- Department of Epidemiology, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands; Department of Bioanalysis, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium
| | - Arnulf Langhammer
- HUNT Research Centre, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, NTNU, Levanger, Norway; Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Bo Lundbäck
- Krefting Research Centre, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Bright I Nwaru
- Krefting Research Centre, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden; Wallenberg Centre for Molecular and Translational Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Eva Rönmark
- Department of Public Health and Clinical Medicine, The OLIN Unit, Section of Sustainable Health, Umeå University, Umeå, Sweden
| | - Sigrid A Aalberg Vikjord
- HUNT Research Centre, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, NTNU, Levanger, Norway; Department of Medicine and Rehabilitation, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Judith M Vonk
- Groningen Research Institute for Asthma and COPD, University of Groningen, University Medical Center Groningen, Groningen, Netherlands; Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Sara R A Wijnant
- Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium; Department of Epidemiology, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands; Department of Bioanalysis, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium
| | - Peter Lange
- Department of Internal Medicine, Section of Respiratory Medicine, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Public Health, Section of Epidemiology, University of Copenhagen, Copenhagen, Denmark
| | - Børge G Nordestgaard
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark; Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Nuria Olvera
- Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain; Centro de Investigación Biomedica en Red Enfermedades Respiratorias, Barcelona, Spain
| | - Alvar Agusti
- Càtedra Salut Respiratòria, Universitat Barcelona, Spain; Respiratory Institute, Hospital Clinic, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain; Centro de Investigación Biomedica en Red Enfermedades Respiratorias, Barcelona, Spain
| | - Gavin C Donaldson
- National Heart and Lung Institute, Imperial College London, London, UK
| | | | - Jørgen Vestbo
- Division of Infection, Immunity and Respiratory Medicine, University of Manchester, Manchester, UK; North West Lung Centre, Manchester University National Health Service Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Lowie E G W Vanfleteren
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; COPD Centre, Department of Respiratory Medicine and Allergology, Sahlgrenska University Hospital, Gothenburg, Sweden
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12
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Kwon DS, Choi YJ, Kim TH, Byun MK, Cho JH, Kim HJ, Park HJ. FEF 25-75% Values in Patients with Normal Lung Function Can Predict the Development of Chronic Obstructive Pulmonary Disease. Int J Chron Obstruct Pulmon Dis 2020; 15:2913-2921. [PMID: 33209020 PMCID: PMC7669499 DOI: 10.2147/copd.s261732] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 10/26/2020] [Indexed: 12/16/2022] Open
Abstract
Purpose The forced mid-expiratory flow (FEF25-75%) value is a potentially sensitive marker of obstructive peripheral airflow. We aimed to assess whether FEF25-75% can be an early predictor of chronic obstructive pulmonary disease (COPD). Patients and Methods Between July 1, 2007 and June 31, 2009, we identified 3624 patients who underwent a pulmonary function test (PFT) in Gangnam Severance Hospital. We selected 307 patients aged over 40 years without COPD who had normal PFT results at baseline and who had follow-up PFT records more than 1 year later. A FEF25-75% z-score less than −0.8435 was considered low. We defined COPD as a forced expiratory volume in one second/forced vital capacity value of less than 0.7 before July 31, 2019. Results Among 307 patients, 91 (29.6%) had low FEF25-75% at baseline. After 10 years, the incidence rate of COPD in the low FEF25-75% group was significantly higher than that in the normal FEF25-75% group (41.8% vs 7.4%; P-value<0.001). The Cox proportional hazard model showed that age (hazard ratio [HR] 1.09; P-value<0.001), smoking status (occasional smoker HR, 4.59; P-value<0.001 and long-term smoker HR, 2.18; P-value=0.023), and low FEF25-75% (HR, 3.31; P-value<0.001) were predictive factors for the development of COPD. Conclusion The FEF25-75% value in patients with normal lung function is a useful predictor for the development of COPD. We should carefully monitor patients who present with low FEF25-75% values, even if they have normal lung function.
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Affiliation(s)
- Do Sun Kwon
- Department of Internal Medicine, Hallym Hospital, Incheon, Korea
| | - Yong Jun Choi
- Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Tae Hee Kim
- Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Min Kwang Byun
- Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Jae Hwa Cho
- Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Hyung Jung Kim
- Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Hye Jung Park
- Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
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13
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Milanzi EB, Koppelman GH, Smit HA, Wijga AH, Vonk JM, Brunekreef B, Gehring U. Timing of secondhand smoke, pet, dampness or mould exposure and lung function in adolescence. Thorax 2019; 75:153-163. [PMID: 31748257 DOI: 10.1136/thoraxjnl-2019-213149] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 10/02/2019] [Accepted: 10/03/2019] [Indexed: 11/04/2022]
Abstract
BACKGROUND The relevance of timing of exposure in the associations of secondhand tobacco smoke (SHS), pets, and dampness or mould exposure with lung function is unclear. We investigated the relevance of timing of these exposures for lung function in adolescence. METHODS We used data from participants of the Dutch Prevention and Incidence of Asthma and Mite Allergy (PIAMA) cohort with spirometric measurements at ages 12 and 16 years (n=552). Data on residential exposure to SHS, pets, and dampness or mould were obtained by repeated parental questionnaires. We characterised timing of exposure through longitudinal patterns using latent class growth modelling and assessed associations of these patterns with FEV1 and FVC at ages 12 and 16 and FEV1 and FVC growth between ages 12 and 16 using linear regression models. RESULTS Childhood SHS exposure was associated with reduced FEV1 growth/year (95% CI) (-0.34% (-0.64% to -0.04%)). Late childhood and early life pet exposure was associated with increased FEV1 growth (0.41% (0.14% to 0.67%)) and reduced FVC growth (-0.28% (-0.53% to -0.03%)), respectively, compared with very low exposure. Early life dampness or mould exposure was associated with reduced lung function growth. All time windows of SHS exposure tended to be associated with lower attained lung function and pet exposure tended to be associated with higher FEV1. CONCLUSION SHS exposure during childhood could lead to reduced lung function growth and lower attained lung function in adolescence. While pet exposure in late childhood may not adversely affect lung function, early childhood pet exposure may slow down FVC growth in adolescence.
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Affiliation(s)
- Edith B Milanzi
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands
| | - Gerard H Koppelman
- Groningen Research Institute for Asthma and COPD (GRIAC), University Medical Center Groningen, Groningen, The Netherlands.,Department of Pediatric Pulmonology and Pediatric Allergology, Beatrix Children's Hospital, University Medical Center Groningen, Groningen, The Netherlands
| | - Henriette A Smit
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Alet H Wijga
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Judith M Vonk
- Groningen Research Institute for Asthma and COPD (GRIAC), University Medical Center Groningen, Groningen, The Netherlands.,Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Bert Brunekreef
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands.,Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Ulrike Gehring
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands
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