Reliability and Validity of Computerized Adventitious Respiratory Sounds in People with Bronchiectasis

Abstract

Background: Computerized adventitious respiratory sounds (ARS), such as crackles and wheezes, have been poorly explored in bronchiectasis, especially their measurement properties. This study aimed to test the reliability and validity of ARS in bronchiectasis. Methods: Respiratory sounds were recorded twice at 4 chest locations on 2 assessment sessions (7 days apart) in people with bronchiectasis and daily sputum expectoration. The total number of crackles, number of wheezes and wheeze occupation rate (%) were the parameters extracted. Results: 28 participants (9 men; 62 ± 12 y) were included. Total number of crackles and wheezes showed moderate within-day (ICC 0.87, 95% CI 0.74–0.94; ICC 0.86, 95% CI 0.71–0.93) and between-day reliability (ICC 0.70, 95% CI 0.43–0.86; ICC 0.78, 95% CI 0.56–0.90) considering all chest locations and both respiratory phases; wheeze occupation rate showed moderate within-day reliability (ICC 0.86, 95% CI 0.71–0.93), but poor between-day reliability (ICC 0.71, 95% CI 0.33–0.87). Bland–Altman plots revealed no systematic bias, but wide limits of agreement, particularly in the between-days analysis. All ARS parameters correlated moderately with the amount of daily sputum expectoration (r > 0.4; p < 0.05). No other significant correlations were observed. Conclusion: ARS presented moderate reliability and were correlated with the daily sputum expectoration in bronchiectasis. The use of sequential measurements may be an option to achieve greater accuracy when ARS are used to monitor or assess the effects of physiotherapy interventions in this population.