Rothe Thomas, Karrer Werner, Schindler Christian
Department of Internal Medicine and Pneumology, Zürcher Höhenklinik Davos , Davos Clavadel, Switzerland.
J Asthma. 2012 Feb;49(1):45-50. doi: 10.3109/02770903.2011.643522. Epub 2011 Dec 28.
Good asthma control is the main goal of long-term asthma treatment. According to the Global Initiative for Asthma (GINA) guidelines (www.ginasthma.com), medical professionals assess asthma control based on specific questions regarding asthma symptoms and by spirometry measuring forced expiratory volume in 1 second (FEV(1)). Patients trained in early self-detection of asthma exacerbations use a symptom-based questionnaire, such as the Asthma Control Test (ACT) [Nathan RA, Sorkness CA, Kosinski M, et al. Development of the Asthma Control Test. A survey for assessing asthma control. J Allergy Clin Immunol 2004; 113:59-64]. However, some patients may prefer harder indicators, like peak flow values, when considering how to act within their regular asthma self-management plan.
Monitoring of FEV(1) at home could be an even more valuable alternative to recording peak flow values. The inexpensive handheld pocket spirometer "Piko-1®" offers the opportunity to monitor and store consecutive FEV(1) values. This study assesses the accuracy of the Piko-1 device.
Twenty volunteers tested 20 Piko-1 devices over five consecutive days. All results were compared to daily FEV(1) values, as measured by a calibrated reference spirometer.
Overall, the accuracy was acceptable, although Piko-1 tended to underestimate FEV(1) in the lower range. Moreover, there was no evidence of major heterogeneity between Piko-1 devices.
The Piko-1 FEV(1) measurements are sufficiently accurate to start a clinical trial to compare the detection of asthma exacerbations with this device and based on asthma symptoms alone.
实现良好的哮喘控制是哮喘长期治疗的主要目标。根据全球哮喘防治创议(GINA)指南(www.ginasthma.com),医学专业人员通过询问有关哮喘症状的特定问题以及通过测量一秒用力呼气量(FEV₁)的肺功能仪来评估哮喘控制情况。接受过哮喘急性发作早期自我检测培训的患者使用基于症状的问卷,如哮喘控制测试(ACT)[内森·R·A,索尔克斯尼斯·C·A,科辛斯基·M等。哮喘控制测试的开发。一项评估哮喘控制情况的调查。《变态反应与临床免疫学杂志》2004年;113:59 - 64]。然而,一些患者在考虑如何在其常规哮喘自我管理计划中采取行动时,可能更喜欢更严格的指标,如峰值流速值。
在家中监测FEV₁可能是记录峰值流速值更有价值的替代方法。廉价的手持式袖珍肺功能仪“Piko - 1®”提供了监测和存储连续FEV₁值的机会。本研究评估了Piko - 1设备的准确性。
20名志愿者在连续五天内测试了20台Piko - 1设备。所有结果均与通过校准的参考肺功能仪测量的每日FEV₁值进行比较。
总体而言,准确性是可以接受的,尽管Piko - 1在较低范围内往往会低估FEV₁。此外,没有证据表明Piko - 1设备之间存在重大异质性。
Piko - 1的FEV₁测量足够准确,可启动一项临床试验,以比较使用该设备与仅基于哮喘症状检测哮喘急性发作的情况。