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Oppelaar MC, van Helvoort H, Bannier MA, Reijers MH, van der Vaart H, van der Meer R, Altenburg J, Conemans L, Rottier BL, Nuijsink M, van den Wijngaart LS, Merkus PJ, Roukema J
Accuracy, Reproducibility, and Responsiveness to Treatment of Home Spirometry in Cystic Fibrosis: Multicenter, Retrospective, Observational Study
Accuracy, reproducibility, and responsiveness to treatment of home spirometry in cystic fibrosis: A Multicentre Retrospective Observational Study.
Martinus C. Oppelaar;
Hanneke van Helvoort;
Michiel A.G.E. Bannier;
Monique H.E. Reijers;
Hester van der Vaart;
Renske van der Meer;
Josje Altenburg;
Lennart Conemans;
Bart L. Rottier;
Marianne Nuijsink;
Lara S. van den Wijngaart;
Peter J.F.M. Merkus;
Jolt Roukema
ABSTRACT
Background:
Portable spirometers are increasingly used to measure lung function at home, but doubts about the accuracy of these devices persist. These doubts stand in the way of the digital transition of chronic respiratory disease care, hence there is a need to address the accuracy of home spirometry in routine care across multiple settings and ages.
Objective:
We aimed to assess accuracy, reproducibility and responsiveness to treatment of home spirometry in long-term paediatric and adult CF care.
Methods:
Retrospective observational study in five Dutch CF centres. Home spirometry outcomes (Forced Expiratory Volume in one second, FEV1; Forced Vital Capacity, FVC) for 601 anonymized users were collected during three years. For 81 users, data on clinic spirometry and elexacaftor/tezacaftor/ivacaftor (ETI) use were available. Accuracy was assessed using Bland-Altman plots. Intra-test reproducibility was assessed with ATS/ERS spirometry quality grades. Responsiveness was measured by %change in home spirometry outcomes after start of ETI.
Results:
No heteroscedasticity was present in the 263 clinic-home spirometry pairs (n=81). Home spirometry was significantly lower than clinic spirometry (Mean ΔFEV1clinic-home 0.13 L; Mean ΔFVCclinic-home 0.20 L) across ages and over time. 5104 unique home measurements were graded. Grade E was given to 2435 tests as only one home measurement was performed. Of the remaining 2669 tests, 43.8% and 43.6% received grade A and B respectively. Median %change in FEV1 from baseline after initiation of ETI was 19.2% after 7-14 days and remained stable thereafter (n=33).
Conclusions:
Home spirometry is feasible but not equal to clinic spirometry. Home spirometry can confirm whether lung functions remain stable, but the context of a measurement and personal trends are more relevant than absolute outcomes.
Citation
Please cite as:
Oppelaar MC, van Helvoort H, Bannier MA, Reijers MH, van der Vaart H, van der Meer R, Altenburg J, Conemans L, Rottier BL, Nuijsink M, van den Wijngaart LS, Merkus PJ, Roukema J
Accuracy, Reproducibility, and Responsiveness to Treatment of Home Spirometry in Cystic Fibrosis: Multicenter, Retrospective, Observational Study