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Abstract
Background
A national health care initiative recommends routine spirometry screening of all smokers over age 45 or patients with respiratory symptoms. In response to the recommendation, new, simple, and inexpensive desktop spirometers for the purpose of promoting widespread spirometric screening were marketed. The performance of these spirometers was evaluated in vivo testing with healthy subjects. However, the clinical setting allows spirometric assessment of various pathologic combinations of flow and volume.
Objective
The aim of this study was to compare the accuracy of a desktop spirometer to a standard laboratory spirometer, in a clinical setting with pathologic pulmonary function.
Method
In a health check-up center, where screening pulmonary funct test was performed using the HI-801 spirometer. Subjects who revealed the ventilation defect in screening spirometry, performed the spirometry again using the standard Vmax spectra 22d spirometer in a tertiary care hospital pulmonary function laboratory. Pulmonary function test with both spirometer was performed according to the guidelines of the American Thoracic Society.
Results
109 patients were enrolled. Pulmonary function measurements (FVC, FEV1, PEFR, FEF25%-75%) from the HI-801 correlated closely (r=0.94, 0.93, 0.81, 0.84, respectively) with those performed with the Vmax spectra 22d and showed the good limits of agreement and differences between the 2 devices; FVC +0.35 L, FEV1 +0.16 L, PEFR +1.85 L/s, FEF25%-75% -0.13 L/s. With the exception of FEV1, FEF25%-75%, these differences were significant(p<0.05) but small.
Figures and Tables
Figure 1
Bivariate correlation analysis between lung function measurements made with the HI-801 and Vmax spirometer.
(A) FVC, (B) FEV1, (C) FEF25%-75%, (D) PEFR.
FEV1: forced expiratory volume in 1 second; FVC: forced vital capacity; PEFR: peak expiratory flow rate; FEF25%-75%: forced expiratory flow at 50% of the forced vital capacity. (p<0.01 for all comparisons).
Figure 2
Differences versus mean values for lung function measurements made with HI-801 and Vmax 22d spirometers.
The solid lines represent the mean differences. The dotted lines represent the upper and lower limits of agreement (±1.96SD) (In Bland Altman plot).
FEV1: forced expiratory volume in 1 second; FVC: forced vital capacity; PEFR: peak expiratory flow rate; FEF25%-75%: forced expiratory flow at 50% of the forced vital capacity.
Table 4
Comparison of measurements from HI-801 and Vmax 22d
Mean±Standard Deviation
*Calculated as mean Vmax 22d reading minus mean HI-801 reading, †p<0.01 using bivariate correlation analysis (r=pearson correlation coefficient), ‡p<0.05 using paired t-test
FEV1: forced expiratory volume in 1 second,; FVC: forced vital capacity; PEFR: peak expiratory flow rate; FEF25%-75%: forced expiratory flow at 50% of the forced vital capacity.
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