Comparison of forced and impulse oscillometry measurements: a clinical population and printed airway model study

Soares, Marcia; Richardson, Matthew; Thorpe, James; Owers-Bradley, John; Siddiqui, Salman

Abstract

The use of commercialised forced oscillation (FOT) devices to assess impedance in obstructive diseases such as asthma has gained popularity. However, it has yet to be fully established whether resistance and reactance measurements are comparable across different FOT devices, particularly in disease. We compared two commercially available FOT devices: Impulse Oscillometry (IOS) and TremoFlo FOT (Thorasys) in a) clinical adult population of healthy controls (n = 14), asymptomatic smokers (n = 17) and individuals with asthma (n = 73) and b) a 3D printed CT-derived airway tree model resistance, as well as a 3 L standardised volume reactance. Bland-Altman Plots and linear regressions were used to evaluate bias between the devices. Resistance measurements at both 5 and 20 Hz were numerically higher with IOS compared to FOT, with evidence of small and statistically significant proportional systematic bias and a positive Bland-Altman regression slope at both 5 and 20 Hz. In contrast, the IOS device recorded reactances that were less negative at both 5 Hz and 20 Hz and significantly smaller reactance areas when compared to TremoFlo. Larger statistically significant proportional systematic biases were demonstrated with both reactance at 5 Hz and reactance area (AX) between the devices with a negative Bland-Altman regression slope. The printed airway resistance and standardised volume reactance confirmed the observations seen in patients. We have demonstrated that the impulse oscillation system and TremoFlo FOT demonstrate comparative bias, particularly when comparing airway reactance in patients. Our results highlight the need for further standardisation across FOT measurement devices, specifically using variable test loads for reactance standardisation.

Citation

Soares, M., Richardson, M., Thorpe, J., Owers-Bradley, J., & Siddiqui, S. (2019). Comparison of forced and impulse oscillometry measurements: a clinical population and printed airway model study. Scientific Reports, 9, Article 2130. https://doi.org/10.1038/s41598-019-38513-x

• Journal Article Type: Article
• Acceptance Date: Nov 26, 2018
• Online Publication Date: Feb 14, 2019
• Publication Date: 2019-12
• Deposit Date: Mar 13, 2019
• Publicly Available Date: Mar 15, 2019
• Journal: Scientific Reports
• Electronic ISSN: 2045-2322
• Publisher: Nature Publishing Group
• Peer Reviewed: Peer Reviewed
• Volume: 9
• Article Number: 2130
• DOI: https://doi.org/10.1038/s41598-019-38513-x
• Public URL: https://nottingham-repository.worktribe.com/output/1637141
• Publisher URL: https://www.nature.com/articles/s41598-019-38513-x
• Additional Information: Received: 1 March 2018; Accepted: 26 November 2018; First Online: 14 February 2019; : Salman Siddiqui has received grants from NIHR, Chiesi and European Union FP7 Scheme: AirPROM-FP7 during the conduct of the study. Salman Siddiqui also reports personal fees from Advisory boards (AZ, GSK, Roche, Boehringer Ingelheim, NAPP, Owlstone and ERT) outside the submitted work. Marcia Soares, James Thorpe, John Owers-Bradley and Matthew Richardson have no competing interests to declare.
• Contract Date: Mar 15, 2019