The interpretation of pulmonary function tests (PFTs) to diagnose respiratory diseases is built on expert opinion that relies on the recognition of patterns and the clinical context for detection of specific diseases. In this study, we aimed to explore the accuracy and interrater variability of pulmonologists when interpreting PFTs compared with artificial intelligence (AI)-based software that was developed and validated in more than 1500 historical patient cases.120 pulmonologists from 16 European hospitals evaluated 50 cases with PFT and clinical information, resulting in 6000 independent interpretations. The AI software examined the same data. American Thoracic Society/European Respiratory Society guidelines were used as the gold standard for PFT pattern interpretation. The gold standard for diagnosis was derived from clinical history, PFT and all additional tests.The pattern recognition of PFTs by pulmonologists (senior 73%, junior 27%) matched the guidelines in 74.4±5.9% of the cases (range 56–88%). The interrater variability of κ=0.67 pointed to a common agreement. Pulmonologists made correct diagnoses in 44.6±8.7% of the cases (range 24–62%) with a large interrater variability (κ=0.35). The AI-based software perfectly matched the PFT pattern interpretations (100%) and assigned a correct diagnosis in 82% of all cases (p<0.0001 for both measures).The interpretation of PFTs by pulmonologists leads to marked variations and errors. AI-based software provides more accurate interpretations and may serve as a powerful decision support tool to improve clinical practice.
What is the optimal treatment strategy for chronic obstructive pulmonary disease exacerbations? W. Willaert, M. Daenen, P. Bomans, G. Verleden, M. Decramer. #ERS Journals Ltd 2002. ABSTRACT: The present study aims to determine whether treating chronic obstructive pulmonary disease (COPD) exacerbations with intravenous steroids and aerosol bronchodilators (group I) is superior to oral steroids and multiple dose inhaler (MDI) bronchodilators with a spacer (group II).Group I received 40 mg methylprednisolone?day -1 intravenously with a decrease to 20 mg after 10 days and a further decrease of 4 mg?4 days -1 . Aerosol therapy consisted of 10 mg salbutamol and 1 mg ipratropiumbromide?day -1 . Group II received 32 mg methylprednisolone orally for 1 week followed by 24 mg?day -1 for 4 days and a subsequent decrease of 4 mg?week -1 . Duovent1 MDI with a spacer was given at a dose of 1.6 mg fenoterol and 640 mg ipratropiumbromide?day -1 . In group I (n=19) forced expiratory volume in one second (FEV1) rose from 0.82¡0.46 to 0.91¡0.47 L and average dyspnoea decreased from 6.0¡1.9 to 4.1¡2.6 within 10 days. The Chronic Respiratory Disease Index Questionnaire (CRQ) score increased from 78¡24 to 90¡24 points after 4 weeks. In group II (n=18) FEV1 increased from 0.70¡0.27 to 0.90¡0.29 L, dyspnoea regressed from 6.2¡2.4 to 2.7¡2.6 and CRQ from 67¡17 to 86¡20. Both groups showed similar results in dropout rate, length of hospital stay and patient satisfaction.In conclusion, the two treatment strategies appear equally effective in treating chronic obstructive pulmonary disease exacerbations, although oral steroids and metered dose inhaler bronchodilators appear associated with a higher risk of hospital re-admission. [8]. Notwithstanding the increase in the number of trials in the last decade evaluating the effect of steroids in COPD, little research has been done to compare orally to intravenously administered steroids when treating an exacerbation in casualty or in patients admitted to hospital.More attention has been given to comparing wet nebulizers to metered dose inhaler (MDI) as a device for bronchodilator delivery in COPD. A meta-analysis by TURNER et al. [9] and numerous other trials have shown the two devices to be equally effective in the treatment of stable [1][2][3][4][5][6][7][8][9][10][11][12] and acute [9] COPD in inand outpatient settings. No difference was reported in the effect of bronchodilation, in pulmonary function tests (PFTs), exercise performance, symptom scores or extra b 2 -agonist use. The degree of bronchodilation was considered to be a reflection of the administered dose rather than the mode of administration.There is no consensus on the optimal route of administration for steroids and the device for bronchodilators. Therefore, a prospective, randomized, controlled trial was conducted to investigate the hypothesis that treatment of COPD exacerbations with oral corticosteroids and MDI bronchodilators, compared to intravenous corticosteroids and aerosol bronchodilators, would not result in different ...
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.