JMIR Publications

ABSTRACT

Background:

International asthma guidelines recommend the monitoring of peak expiratory flow (PEF) as part of asthma self-management. Measured with a peak flow meter, it represents a person’s maximum speed of expiration and helps individuals to follow their disease evolution and ultimately to prevent asthma exacerbations. However, adherence to this practice is poor, particularly in the pediatric population. To address this, we developed an interactive serious game consisting of a portable game controller that can transduce a signal from the breath to generate a PEF value when coupled with a tablet-based game.

Objective:

We evaluated the concordance between PEF values obtained with the game controller (PEFGC) and various measures derived from conventional pulmonary function tests (i.e spirometry) and we synthesized the participants’ feedback.

Methods:

In this cross-sectional multicenter study, 158 children aged 8-15 years old with a diagnosis or suspicion of asthma performed spirometry and played with the game in one of 2 hospital university centers. We evaluated the correlation between PEFGC and spirometry measurements, including PEF values (PEFspiro), forced expiratory volume in 1 second (FEV1) and forced expiratory volume at 25-75% of pulmonary volume (FEF25-75), using Spearman correlation. A Bland-Altman plot was generated for comparison of PEFGC against PEFspiro. A post-game user feedback questionnaire was administered and analyzed.

Results:

The participants had a mean age (SD) of 10.9 (2.5) years, 44% were female, and 88.6% Caucasians. On average, their pulmonary function were normal, including FEV1, PEF and FEV1/FVC. The PEFGC was reproducible in 96.2% of participants according to standardized criteria. The PEFGC presented a good correlation with PEFspiro (r=0.83, p<0.001), with FEV1 (r=0.74, p<0.001) and with FEF25-75 (r=0.65, p<0.001). The PEFGC presented an expected mean bias of -36.4 L/min as compared to PEFspiro. The participants’ feedback was strongly positive with 78.4% reporting they would use the game if they had it at home.

Conclusions:

The game controller developed is an interactive tool appreciated by children with asthma and whose values are reproducible with a good correlation when compared to conventional spirometry. Future studies are necessary to evaluate the clinical impact this novel tool might have on asthma management and its potential use in an out-of-hospital setting.