Longitudinal monitoring of asthma in the clinic using respiratory oscillometry
| Autor: | Claude S. Farah, Tanya Badal, Cindy Thamrin, Leigh M. Seccombe, Alice M. Cottee, Matthew J. Peters, Gregory G. King |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
Pulmonary and Respiratory Medicine Spirometry medicine.medical_specialty Concordance 03 medical and health sciences 0302 clinical medicine Forced Expiratory Volume Oscillometry Asthma control Internal medicine medicine Humans 030212 general & internal medicine Respiratory system Asthma medicine.diagnostic_test business.industry medicine.disease Respiratory Function Tests respiratory tract diseases 030228 respiratory system Exhaled nitric oxide Cohort business |
| Zdroj: | Respirology. 26:566-573 |
| ISSN: | 1440-1843 1323-7799 |
| DOI: | 10.1111/resp.14053 |
| Popis: | Background and objective Asthma guidelines emphasize the importance of assessing lung function and symptoms. The forced oscillation technique (FOT) and its longitudinal relationship with spirometry and symptoms are unresolved. We examined concordance between longitudinal spirometry, FOT and symptom control, and determined FOT limits of agreement in stable asthma. Methods Over a 3-year period, adults with asthma attending a tertiary clinic completed the asthma control test (ACT), fraction of exhaled nitric oxide (FeNO), FOT and spirometry. Analysis included between-visit concordance for significant change using Cohen's kappa (κ) and stable asthma FOT limits of agreement. Results Data (n = 186) from 855 visits (mean ± SD 4.6 ± 3.0 visits), 114 ± 95 days apart, were analysed. Between-visit concordance was moderate between reactance at 5 Hz (X5) and forced expiratory volume in 1 s (FEV1 ) (κ = 0.34, p = 0.001), and weak between ACT and FEV1 (κ = 0.18, p = 0.001). Change in FeNO did not correlate with lung function or ACT (κ 0.1). Stable asthma between visits (n = 75; 132 visits) had reduced lung function variability, but comparable concordance to the entire cohort. Limits of agreement for FEV1 (0.42 L), resistance at 5 Hz (2.06 cm H2 O s L-1 ) and X5 (2.75 cm H2 O s L-1 ) in stable asthma were at least twofold greater than published values in health. Conclusion In adults with asthma, there is moderate concordance between longitudinal change in FOT and spirometry. Both tests relate poorly to changes in asthma control, highlighting the need for multi-modal assessment in asthma rather than symptoms alone. The derivation of longitudinal FOT limits of agreement will assist in its clinical interpretation. |
| Databáze: | OpenAIRE |
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