Airborne Hazards and Burn Pits Center of Excellence, War Related Illness and Injury Study Center, VA New Jersey Health Care System, 385 Tremont Ave, East Orange, NJ, 07018, USA.
Rutgers New Jersey Medical School, Rutgers Biomedical and Health Sciences, Newark, NJ, USA.
Sci Rep. 2022 Jul 30;12(1):13119. doi: 10.1038/s41598-022-17264-2.
Forced oscillation technique (FOT) provides unique information on respiratory system mechanical properties complementing pulmonary function testing. However, a lack of evidence guiding acquisition/reporting of parameters has slowed clinical FOT adoption. Current European Respiratory Society (ERS) standards recommend 3-5 trials per session comprising three trials with a coefficient of variation (CoV) ≤ 10% for low-frequency resistance. We present an analysis of different combinations of trial selection methods and session validity thresholding variables (low- and mid-frequency resistance and reactance [R5, R19, X5], low-frequency reactance area [AX] and tidal volume) comparing proportion of subjects achieving valid data across two test sessions (7 ± 3 days apart) and within and between session measurement variabilities. 126 (98%) subjects achieved valid data across both sessions (2666 trials). With R5 or R19 as criteria and selection of any three trials from ≥ 4 attempts, ≥ 75% of subjects achieved validity. Furthermore, with R5 or R19 criteria and selection of any trials from ≥ 5 attempts, CoVs for resistance outcomes were reduced within session while variabilities of FOT outcomes between sessions remained consistent. Within session differences in measurement variabilities were not clinically meaningful. Our analyses support current ERS reporting recommendations for healthy adults. Future work should apply this analytic approach to patient populations.
呼吸力学多频震荡技术（FOT）提供了独特的呼吸系统机械特性信息，补充了肺功能测试。然而，由于缺乏关于参数采集和报告的证据，临床 FOT 的应用进展缓慢。目前，欧洲呼吸学会（ERS）标准建议每次检测进行 3-5 次测试，其中低频率阻力的 3 次测试的变异系数（CoV）应≤10%。我们分析了不同的试验选择方法和检测有效性阈值变量（低频率和中频率阻力和电抗[R5、R19、X5]、低频率电抗面积[AX]和潮气量）组合，比较了两个检测间隔 7±3 天的测试中，达到有效数据的受试者比例，以及检测内和检测间的测量变异性。126（98%）名受试者在两个检测中都获得了有效的数据（2666 次测试）。如果 R5 或 R19 作为标准，并且从≥4 次尝试中选择任意三个试验，则≥75%的受试者可获得有效性。此外，如果使用 R5 或 R19 作为标准，并且从≥5 次尝试中选择任意试验，则可降低检测内的阻力结果的 CoV，同时保持检测间的 FOT 结果的变异性。检测内测量变异性的差异没有临床意义。我们的分析支持当前 ERS 对健康成年人的报告建议。未来的工作应该将这种分析方法应用于患者群体。
