The Future of Pulmonary Function Testing

MacIntyre, Neil R.

doi:10.4187/respcare.01422

Cited by 17 publications

(13 citation statements)

References 49 publications

(47 reference statements)

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“…This approach will probably not be sufficient in the future. 42 The ultimate goal of each PFT should be to predict outcomes, such as quality of life, morbidity/mortality, or the risks and benefits of a particular intervention. This will require not only very accurate and repeatable tests, but integrating the results into clinical decision making.…”

Section: Pft Lab Of the Futurementioning

confidence: 99%

Pulmonary Function Testing

2012

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Pulmonary function testing is often considered the basis for diagnosis in many categories of pulmonary disease. Although most of the testing methodologies are well established and widely employed, there are still many questions regarding how tests should be performed, how to ensure that reliable data are produced, what reference values and rules should be used, and how pulmonary function tests (PFTs) should be interpreted to best support clinical decision making. This conference was organized around a set of questions aimed at many of these issues. Each presenter was asked to address a specific topic regarding what tests should be done, how those test should be performed to answer a particular clinical question, and to relate test results to an accurate diagnosis and appropriate treatment of the patient. These topics included testing of adults and children, with concentration on important disease entities such as COPD, asthma, and unexplained dyspnea. Special emphasis was given to discussing reference values, lower limits of normal, interpretive strategies to optimize disease classification, and those factors directly affecting data quality. Established techniques for spirometry, lung volumes, diffusing capacity, exercise testing, and bronchial challenges were compared and contrasted with new technologies, and with technologies that might be part of pulmonary function laboratories in the near future.

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Section: Pft Lab Of the Futurementioning

confidence: 99%

Pulmonary Function Testing

2012

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“…Due to several recent technical enhancements, FOT currently represents state of the art in lung function evaluation [10]. Several authors have argued that it has the potential to improve diagnosis and monitor the treatment of respiratory diseases and that further studies are needed in this area [11,12]. In this context, the FOT and the associated traditional parameters have been used to simplify the routine evaluation and to improve our understanding of the pathophysiology of several respiratory diseases [8].…”

Section: Introductionmentioning

confidence: 99%

Combined forced oscillation and fractional-order modeling in patients with work-related asthma: a case-control study analyzing respiratory biomechanics and diagnostic accuracy

Tuza

Sá²,

Castro

et al. 2020

Preprint

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Background Fractional-order (FrOr) models have a high potential to improve pulmonary science. These models could be useful for biomechanical studies and diagnostic purposes, offering accurate models with an improved ability to describe nature. This paper evaluates the performance of the Forced Oscillation (FO) associated with integer (InOr) and FrOr models in the analysis of respiratory alterations in work-related asthma (WRA). Methods Sixty-two individuals were evaluated: 31 healthy and 31 with WRA with mild obstruction. Patients were analyzed pre and post bronchodilation. The diagnostic accuracy was evaluated using the area under the receiver operating characteristic curve (AUC). To evaluate how well do the studied models correspond to observed data, we analyzed the mean square root of the sum (MSEt) and the relative distance (Rd) of the estimated model values to the measured resistance and reactance measured values. Results and discussion Initially, the use of InOr and FrOr models increased our understanding of the WRA physiopathology, showing increased peripheral resistance, damping, and hysteresivity. The FrOr model (AUC=0.970) outperformed standard FO (AUC=0.929), as well as InOr modeling (AUC=0.838) in the diagnosis of respiratory changes, achieving high accuracy. FrOr improved the curve fitting (MSEt=0.156±0.340; Rd=3.026±1.072) in comparison with the InOr model (MSEt=0.367±0.991; Rd=3.363±1.098). Finally, we demonstrated that the bronchodilator use increased dynamic compliance, as well as reduced damping and peripheral resistance. Conclusions Taken together, these results show clear evidence of the utility of FO associated with fractional-order modeling in patients with WRA, improving our knowledge of the biomechanical abnormalities and the diagnostic accuracy in this disease.

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“…Measurements of lung volumes are used in clinical practice in order to screen for functional abnormalities and to estimate the degree of loss of pulmonary function [1][2][3][4][5][6][7][8][9] . One of these volumes is the slow vital capacity (SVC), defined as the largest amount of air a person can exhale, slowly, after a maximal inspiration 2,3,6 .…”

Section: Introductionmentioning

confidence: 99%

“…One of these volumes is the slow vital capacity (SVC), defined as the largest amount of air a person can exhale, slowly, after a maximal inspiration 2,3,6 . A complete pulmonary functional evaluation includes many other measurements 7 , but we have been investigating the SVC and the single-breath counting test (NC abbreviation for numerical counting) as quantitative screening tools for obstructive or restrictive processes in circumstances where more refined and costly equipment to measure functional deficits are not available [10][11][12] . We have also studied the utility of the maximal phonation time (MPT).…”

Section: Introductionmentioning

confidence: 99%

Accuracy of single-breath counting test to determine slow vital capacity in hospitalized patients

et al. 2019

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Purpose: to identify the accuracy of the single-breath counting test to determine slow vital capacity in hospitalized patients and to evaluate the repeatability of the same examiner. Methods: a diagnostic study and the choice of techniques were randomly assigned. The area under the curve (receiver operating characteristic) was calculated from the slow vital capacity (20ml/kg) to evaluate the best psychometric characteristics of single-breath counting Test for this cutoff point. Repeatability observed by the same examiner was assessed using the Intraclass Correlation Coefficient. Results: 516 patients hospitalized for various diseases were analyzed. In the curve analysis (receiver operating characteristic/slow vital capacity=20ml/Kg), the value of 21 in single-breath counting test with a sensitivity of 94.44% and specificity of 76.62% (area under the curve =0.93, p<0.005) was found. The intraclass correlation coefficient value for the single-breath counting test was 0.976 with p>0.005. Conclusion: the single-breath counting test was a valid and repetitive technique, and may be an important screening option for assessment of lung function in the absence of specific equipment. This technique opens perspectives to replace slow vital capacity measurement in hospitals, which lack spirometric equipment, or in patients who may have a contagious disease, which has a risk of contamination and spread of disease from one patient to another.

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The Future of Pulmonary Function Testing

Cited by 17 publications

References 49 publications

Pulmonary Function Testing

Pulmonary Function Testing

Combined forced oscillation and fractional-order modeling in patients with work-related asthma: a case-control study analyzing respiratory biomechanics and diagnostic accuracy

Accuracy of single-breath counting test to determine slow vital capacity in hospitalized patients

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