Revisiting the accuracy of peak flow meters: a double-blind study using formal methods of agreement

Nazir, Zulfiqar; Razaq, Samar; Mir, Samina; Anwar, M. M.; Mawlawi, G Al; Sajad, Mohd; Shehab, Abdullah; Taylor, R

doi:10.1016/j.rmed.2004.10.015

Cited by 22 publications

(17 citation statements)

References 12 publications

(15 reference statements)

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“…Whereas this study did utilize human subjects, the use of a qualified examiner and of standard verbal commands assured that the effort demanded during the PEF measurement was the subject’s maximum and was similar for all of the meters. According to Nazir et al14 and Pretto et al (and cited by Koyama et al8), despite the fact that measurements obtained with human subjects may be less accurate than those made with flow generating equipment, it has been suggested that the measurements obtained with human subjects are more clinically significant.…”

Section: Discussionmentioning

confidence: 99%

“…Many different studies have focused on testing the accuracy of these meters by comparing devices from different manufacturers and equipments from the same brand; these studies have revealed significant inter- and intra-meter variations 1,5,7,8,11–14. In these studies different methods were used to evaluate the accuracy of the peak flow meters, such as a flow generator acknowledged and recommended by the American Thoracic Society (ATS), the collaboration of individuals generating flow in a spirometer connected in series to the meters, or to separate the performance of spirometry measurements with several peak flow meters, with subsequent comparison of the results.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of five portable peak flow meters

Takara

Ruas

Pessoa

et al. 2010

Clinics

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OBJECTIVETo compare the measurements of spirometric peak expiratory flow (PEF) from five different PEF meters and to determine if their values are in agreement. Inaccurate equipment may result in incorrect diagnoses of asthma and inappropriate treatments.METHODSSixty-eight healthy, sedentary and insufficiently active subjects, aged from 19 to 40 years, performed PEF measurements using Air Zone®, Assess®, Galemed®, Personal Best® and Vitalograph® peak flow meters. The highest value recorded for each subject for each device was compared to the corresponding spirometric values using Friedman’s test with Dunn’s post-hoc (p<0.05), Spearman’s correlation test and Bland-Altman’s agreement test.RESULTSThe median and interquartile ranges for the spirometric values and the Air Zone®, Assess®, Galemed®, Personal Best® and Vitalograph® meters were 428 (263–688 L/min), 450 (350–800 L/min), 420 (310–720 L/min), 380 (300–735 L/min), 400 (310–685 L/min) and 415 (335–610 L/min), respectively. Significant differences were found when the spirometric values were compared to those recorded by the Air Zone® (p<0.001) and Galemed ® (p<0.01) meters. There was no agreement between the spirometric values and the five PEF meters.CONCLUSIONSThe results suggest that the values recorded from Galemed® meters may underestimate the actual value, which could lead to unnecessary interventions, and that Air Zone® meters overestimate spirometric values, which could obfuscate the need for intervention. These findings must be taken into account when interpreting both devices’ results in younger people. These differences should also be considered when directly comparing values from different types of PEF meters.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Comparison of five portable peak flow meters

Takara

Ruas

Pessoa

et al. 2010

Clinics

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“…One important caveat is that some of these portable devices may not be as accurate or consistent or reproducible with results as reproducible as the more expensive equipment available in the clinician's office. [62][63][64] In addition, measurements made with devices that record numerical values for FEV 1 but do not record full flow-volume curves are subject to possible misinterpretation if the patient has laryngeal dysfunction.…”

Section: Evaluation Of Eiamentioning

confidence: 99%

American Academy of Allergy, Asthma & Immunology Work Group Report: Exercise-induced asthma

Weiler

Бонини

Coifman

et al. 2007

Journal of Allergy and Clinical Immunology

215

152

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“…The application of multiple or a combination of methods, particularly in the assessment of agreement, suggests that there is no consensus among researchers on which method is the best statistical method for measuring agreement. One example of the multiple application of method is in one study that testing the accuracy of peak flow meters [24]. In this study, the authors applied three statistical methods (Pearson's correlation coefficient, comparing mean (significant test) and the Bland-Altman method) to assess for agreement of peak flow meters [24].…”

Section: Application Of Multiple Methodsmentioning

confidence: 99%

“…One example of the multiple application of method is in one study that testing the accuracy of peak flow meters [24]. In this study, the authors applied three statistical methods (Pearson's correlation coefficient, comparing mean (significant test) and the Bland-Altman method) to assess for agreement of peak flow meters [24].…”

Section: Application Of Multiple Methodsmentioning

confidence: 99%

Validation of Instrument Measuring Continuous Variable in Medicine

Zaki¹

2017

Advances in Statistical Methodologies and Their Application to Real Problems

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In medicine, accurate measurement of clinical values is vital, either at the stage of health screening, diagnosing cases or making prognosis. There are numerous instruments or machines that have been invented for the purpose of measuring various clinical variables such as blood pressure, glucose level, body temperature and oxygen level. When a new method of measurement or instrument is invented, the quality of the instrument has to be assessed. This chapter will focus on the application of statistical methods used to analyse continuous data in a method comparison study or validation study in medicine. The concept of validity and analysis in method comparison study will be discussed. This chapter also reviews the theoretical aspects of several common methods and approaches that have been used to measure agreement and reliability including the Bland-Altman limits of agreement (LoA) and intra-class correlation coefficient (ICC). Issues related to method comparison studies will be highlighted, which include the evaluation of agreement and reliability in a single study, the application of multiple statistical methods and the use of inappropriate methods in testing agreement and reliability. Finally, the importance of education in method comparison studies among medical professional will be emphasized.

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Revisiting the accuracy of peak flow meters: a double-blind study using formal methods of agreement

Abstract: There was a significant difference between the values obtained from the new and old peak flow meters and also between the two new peak flow meters. We conclude that there is need for caution in interchangeably using flow meters in clinical practice.

Cited by 22 publications

References 12 publications

Comparison of five portable peak flow meters

Comparison of five portable peak flow meters

American Academy of Allergy, Asthma & Immunology Work Group Report: Exercise-induced asthma

Validation of Instrument Measuring Continuous Variable in Medicine

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