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Clinical Investigations: PULMONARY FUNCTION TEST |

Pulmonary Function Electronic Monitoring Devices*: A Randomized Agreement Study

Joao A. Fonseca, MD; Altamiro Costa-Pereira, MD, PhD; Luis Delgado, MD, PhD; Luis N. Silva; Manuel Magalhães; M. Graca Castel-Branco, MD; Marianela Vaz, MD
Author and Funding Information

*From the Imunoallergology Division (Drs. Fonseca, Castel-Branco, and Vaz), São João Hospital; and Biostatistics and Medical Informatics Department (Drs. Costa-Pereira, Silva, and Mr. Magalhães), and Immunology Department (Dr. Delgado), Faculdade de Medicina, Universidade do Porto, Porto, Portugal.

Correspondence to: Joao A. Fonseca, MD, Biostatistics and Medical Informatics Department, Faculdade de Medicina, Alameda Hernani Monteiro, 4202–451 Porto, Portugal; e-mail: jfonseca@med.up.pt



Chest. 2005;128(3):1258-1265. doi:10.1378/chest.128.3.1258
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Study objectives: To compare in a clinical setting the within-session reproducibility of two pulmonary function electronic monitoring devices (PiKo-1; Ferraris Respiratory Europe; Hereford, UK; and Spirotel; MIR; Rome, Italy) with one mechanical device (Mini-Wright Peak-Flow Meter; Clement-Clarke International; Harlow, Essex, UK), and to evaluate the accuracy of these devices using as reference an office pneumotachograph.

Design, setting, and participants: After detailed instructions, adults without airways diseases and patients with stable asthma attending an outpatient clinic performed four sets of expiratory maneuvers, one set for each device, in a strictly random order. Each set comprised three maneuvers with 2 to 3 min of rest between them.

Measurements: Reproducibility of FEV1 and peak expiratory flow (PEF) was assessed by a coefficient of variation (CV) and intraclass correlation coefficient (ICC), and accuracy was assessed by ICC and limits of agreement.

Results: Of the 38 participants evaluated, 71% were women and 61% had asthma. Ages ranged from 18 to 58 years, and FEV1 ranged from 1.2 to 4.8 L. In all monitoring devices, CV was < 6% and ICC was > 0.94 for the reproducibility of both FEV1 and PEF measurements. The accuracy of the PiKo-1 device was better for FEV1 (ICC = 0.98) than for PEF (ICC = 0.90). The Spirotel device had similar results for FEV1 and PEF (ICC = 0.95). The Mini-Wright device had the lowest accuracy (ICC = 0.87), particularly for PEF values < 500 L/min.

Conclusions: These low-cost and easy-to-use electronic monitoring devices showed a very good reproducibility and were in agreement with the pneumotachograph. Therefore, the PiKo-1 and Spirotel devices seem adequate for both screening and monitoring. However, prospective studies are still needed to assess their long-term reproducibility and usability and, particularly, the effects on the improvement of respiratory care.

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