Khor Yet H, Poberezhets Vitalii, Buhr Russell G, Chalmers James D, Choi Hayoung, Fan Vincent S, George Maureen, Holland Anne E, Pinnock Hilary, Ryerson Christopher J, Alder Rachel, Aronson Kerri I, Barnes Teresa, Benzo Roberto, Birring Surinder S, Boyd Jeanette, Crossley Barbara, Flewett Ron, Freedman Michael, Gibson Toni, Houchen-Wolloff Linzy, Krishnaswamy Uma M, Linnell John, Martinez Fernando J, Moor Catharina C, Orr Hilarry, Pappalardo Andrea A, Saraiva Isabel, Wadell Karin, Watz Henrik, Wijsenbeek Marlies S, Krishnan Jerry A
Am J Respir Crit Care Med. 2025 Feb;211(2):174-193. doi: 10.1164/rccm.202410-2080ST.
There is increasing interest in the use of home-based monitoring in people with chronic lung diseases to improve access to care, support patient self-management, and facilitate the collection of information for clinical care and research. However, integration of home-based monitoring into clinical and research settings requires careful consideration of test performance and other attributes. There is no published guidance from professional respiratory societies to advance the science of home-based monitoring for chronic lung disease. An international multidisciplinary panel of 32 clinicians, researchers, patients, and caregivers developed a multidimensional framework for the evaluation of home-based monitoring in chronic lung disease developed through consensus using a modified Delphi survey. We also present an example of how the framework could be used to evaluate home-based monitoring using spirometry and pulse oximetry in adults with asthma, bronchiectasis/cystic fibrosis, chronic obstructive pulmonary disease, and interstitial lung disease. The PANACEA framework includes seven domains (test Performance, disease mANAgement, Cost, patient Experience, clinician Experience, researcher Experience, and Access) to assess the degree to which home-based monitoring assessments meet the conditions for clinical and research use in chronic lung disease. Knowledge gaps and recommendations for future research of home spirometry and pulse oximetry in asthma, bronchiectasis/cystic fibrosis, chronic obstructive pulmonary disease, and interstitial lung disease were identified. The development of the PANACEA framework allows standardized evaluation of home-based monitoring in chronic lung diseases to support clinical application and future research.
对于在慢性肺病患者中使用家庭监测以改善医疗服务可及性、支持患者自我管理并促进临床护理和研究信息收集的兴趣与日俱增。然而，将家庭监测整合到临床和研究环境中需要仔细考虑测试性能和其他属性。专业呼吸学会尚未发布推进慢性肺病家庭监测科学的指南。一个由32名临床医生、研究人员、患者和护理人员组成的国际多学科小组通过使用改良德尔菲调查达成共识，制定了一个评估慢性肺病家庭监测的多维框架。我们还给出了一个示例，说明该框架如何用于评估成人哮喘、支气管扩张/囊性纤维化、慢性阻塞性肺疾病和间质性肺疾病患者使用肺活量测定法和脉搏血氧测定法进行的家庭监测。PANACEA框架包括七个领域（测试性能、疾病管理、成本、患者体验、临床医生体验、研究人员体验和可及性），以评估家庭监测评估在多大程度上满足慢性肺病临床和研究使用的条件。确定了哮喘、支气管扩张/囊性纤维化、慢性阻塞性肺疾病和间质性肺疾病中家庭肺活量测定法和脉搏血氧测定法的知识差距和未来研究建议。PANACEA框架的制定允许对慢性肺病家庭监测进行标准化评估，以支持临床应用和未来研究。
