Xiaolin Liang1, Jinping Zheng1, Yi Gao1, Zhe Zhang1, Wen Han2, Jing Du3, Yong Lu4, Li Chen5, Tao Wang6, Jinming Liu7, Gang Huang8, Bingrong Zhao9, Guihua Zhao10, Xuhua Zhang11, Yi Peng12, Xin Chen13, Ning Zhou14. 1. National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China. 2. Dept of Respiratory and Critical Care Medicine, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China. 3. Dept of Respiratory and Critical Care, West China Hospital, Sichuan University, Chengdu, China. 4. Dept of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China. 5. Dept of Respiratory Medicine, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China. 6. Dept of Respiratory and Critical Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. 7. Dept of Pulmonary Circulation, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China. 8. Key Laboratory of Respiratory Disease of Zhejiang Province, Dept of Respiratory and Critical Care Medicine, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China. 9. Dept of Respiratory Medicine, National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, Changsha, China. 10. Dept of Cardiopulmonary function, Henan Provincial People's Hospital, Zhengzhou, China. 11. Dept of Pulmonary Function Test, Ningxia Medical University General Hospital, Yinchuan, China. 12. Dept of Respiratory Medicine, Union Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. 13. Dept of Respiratory and Critical Care Medicine, Zhujiang Hospital of Southern Medical University, Guangzhou, China. 14. Dept of Respiratory and Critical Care Medicine, Tianjin Medical University General Hospital, Tianjin, China.
Abstract
Background: Respiratory oscillometry is a promising complement to the traditional pulmonary function tests for its simplicity. The usefulness of oscillometry in adult clinical practice has not been clarified. This study aimed to analyse the characteristics and diagnostic performance of oscillometry in respiratory diseases, and explore the cut-offs of oscillometric parameters for severity grading. Methods: In this multicentre registry of impulse oscillometry (IOS), IOS and spirometric data of healthy individuals and patients with respiratory diseases were collected and analysed. Linear mixed model analysis was performed to explore the effects of disease and forced expiratory volume in 1 s (FEV1) on oscillometric parameters. Results: The study included 567 healthy subjects, 781 asthmatic patients, 688 patients with chronic obstructive pulmonary disease (COPD), 109 patients with bronchiectasis, 40 patients with upper airway obstruction (UAO) and 274 patients with interstitial lung disease (ILD) in the analysis. Compared at the same FEV1 level, asthma, COPD, bronchiectasis, UAO and ILD displayed different oscillometric characteristics. The z-score of resistance at 5 Hz (R 5) was the best variable to identify respiratory diseases with a sensitivity of 62.4-66.7% and a specificity of 81.5-90.3%. With reference to the severity grading cut-offs of FEV1, R 5 z-scores of 2.5 and 4 were defined as the cut-off values of moderately and severely increased R 5. Conclusion: Respiratory oscillometry is more appropriate to be a tool of evaluating, rather than of diagnosing, respiratory diseases. A severity grading system of oscillometric parameters was developed to help the interpretation of oscillometry in clinical practice.
Background: Respiratory oscillometry is a promising complement to the traditional pulmonary function tests for its simplicity. The usefulness of oscillometry in adult clinical practice has not been clarified. This study aimed to analyse the characteristics and diagnostic performance of oscillometry in respiratory diseases, and explore the cut-offs of oscillometric parameters for severity grading. Methods: In this multicentre registry of impulse oscillometry (IOS), IOS and spirometric data of healthy individuals and patients with respiratory diseases were collected and analysed. Linear mixed model analysis was performed to explore the effects of disease and forced expiratory volume in 1 s (FEV1) on oscillometric parameters. Results: The study included 567 healthy subjects, 781 asthmatic patients, 688 patients with chronic obstructive pulmonary disease (COPD), 109 patients with bronchiectasis, 40 patients with upper airway obstruction (UAO) and 274 patients with interstitial lung disease (ILD) in the analysis. Compared at the same FEV1 level, asthma, COPD, bronchiectasis, UAO and ILD displayed different oscillometric characteristics. The z-score of resistance at 5 Hz (R 5) was the best variable to identify respiratory diseases with a sensitivity of 62.4-66.7% and a specificity of 81.5-90.3%. With reference to the severity grading cut-offs of FEV1, R 5 z-scores of 2.5 and 4 were defined as the cut-off values of moderately and severely increased R 5. Conclusion: Respiratory oscillometry is more appropriate to be a tool of evaluating, rather than of diagnosing, respiratory diseases. A severity grading system of oscillometric parameters was developed to help the interpretation of oscillometry in clinical practice.
Authors: Brian L Graham; Irene Steenbruggen; Martin R Miller; Igor Z Barjaktarevic; Brendan G Cooper; Graham L Hall; Teal S Hallstrand; David A Kaminsky; Kevin McCarthy; Meredith C McCormack; Cristine E Oropez; Margaret Rosenfeld; Sanja Stanojevic; Maureen P Swanney; Bruce R Thompson Journal: Am J Respir Crit Care Med Date: 2019-10-15 Impact factor: 21.405