Abstract
BACKGROUND—Handheld electronic spirometers provide the opportunity for more comprehensive monitoring of lung function at home than has hitherto been available. The aim of this study was to assess the quality of spirometric data collected at home by 90 asthmatic schoolchildren aged 7-14 years. METHODS—After training, children carried out twice daily recordings at home for four consecutive periods of 4 weeks using a data storage spirometer (Vitalograph), encouraged by 4-weekly visits from a research nurse. Compliance (proportion of blows recorded at correct time of day), technical quality (by machine criteria), and valid data recorded (the multiple of compliance and technical ability) were assessed. RESULTS—Mean compliance declined from 81.4% to 70.4% (p<0.001) between the first and last month, although the technical quality of the manoeuvres (81.9% and 80.1%, respectively) did not change significantly (p=0.48). CONCLUSIONS—There was a steady reduction of valid data over the four periods (from 73.6% to 64.3%, 59.7%, and 57.6%) with wide individual differences. Even under ideal conditions, home spirometry provides an incomplete (and therefore potentially biased) picture of long term changes in pulmonary function.
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Selected References
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- Charlton I., Charlton G., Broomfield J., Mullee M. A. Evaluation of peak flow and symptoms only self management plans for control of asthma in general practice. BMJ. 1990 Dec 15;301(6765):1355–1359. doi: 10.1136/bmj.301.6765.1355. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Chowienczyk P. J., Parkin D. H., Lawson C. P., Cochrane G. M. Do asthmatic patients correctly record home spirometry measurements? BMJ. 1994 Dec 17;309(6969):1618–1618. doi: 10.1136/bmj.309.6969.1618. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Gannon P. F., Belcher J., Pantin C. F., Burge P. S. The effect of patient technique and training on the accuracy of self-recorded peak expiratory flow. Eur Respir J. 1999 Jul;14(1):28–31. doi: 10.1034/j.1399-3003.1999.14a07.x. [DOI] [PubMed] [Google Scholar]
- Hankinson J. L., Bang K. M. Acceptability and reproducibility criteria of the American Thoracic Society as observed in a sample of the general population. Am Rev Respir Dis. 1991 Mar;143(3):516–521. doi: 10.1164/ajrccm/143.3.516. [DOI] [PubMed] [Google Scholar]
- Hoek G., Brunekreef B. Time trends in repeated spirometry in children. Eur Respir J. 1992 May;5(5):553–559. [PubMed] [Google Scholar]
- Hyland M. E., Kenyon C. A., Allen R., Howarth P. Diary keeping in asthma: comparison of written and electronic methods. BMJ. 1993 Feb 20;306(6876):487–489. doi: 10.1136/bmj.306.6876.487. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Miller M. R., Dickinson S. A., Hitchings D. J. The accuracy of portable peak flow meters. Thorax. 1992 Nov;47(11):904–909. doi: 10.1136/thx.47.11.904. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Pelkonen A. S., Nikander K., Turpeinen M. Reproducibility of home spirometry in children with newly diagnosed asthma. Pediatr Pulmonol. 2000 Jan;29(1):34–38. doi: 10.1002/(sici)1099-0496(200001)29:1<34::aid-ppul6>3.0.co;2-o. [DOI] [PubMed] [Google Scholar]
- Redline S., Wright E. C., Kattan M., Kercsmar C., Weiss K. Short-term compliance with peak flow monitoring: results from a study of inner city children with asthma. Pediatr Pulmonol. 1996 Apr;21(4):203–210. doi: 10.1002/(SICI)1099-0496(199604)21:4<203::AID-PPUL1>3.0.CO;2-P. [DOI] [PubMed] [Google Scholar]
- Studnicka M., Frischer T., Neumann M. Determinants of reproducibility of lung function tests in children aged 7 to 10 years. Pediatr Pulmonol. 1998 Apr;25(4):238–243. doi: 10.1002/(sici)1099-0496(199804)25:4<238::aid-ppul4>3.0.co;2-g. [DOI] [PubMed] [Google Scholar]
- Tzelepis G. E., Zakynthinos S., Vassilakopoulos T., Geroulanos S., Roussos C. Inspiratory maneuver effects on peak expiratory flow. Role of lung elastic recoil and expiratory pressure. Am J Respir Crit Care Med. 1997 Nov;156(5):1399–1404. doi: 10.1164/ajrccm.156.5.9702009. [DOI] [PubMed] [Google Scholar]
- Uwyyed K., Springer C., Avital A., Bar-Yishay E., Godfrey S. Home recording of PEF in young asthmatics: does it contribute to management? Eur Respir J. 1996 May;9(5):872–879. doi: 10.1183/09031936.96.09050872. [DOI] [PubMed] [Google Scholar]