A comparison of clinic and home spirometry as longtudinal outcomes in cystic fibrosis.
J Cyst Fibros
; 21(1): 78-83, 2022 01.
Article
in English
| MEDLINE | ID: covidwho-1377747
ABSTRACT
BACKGROUND:
The COVID-19 pandemic has accelerated the transition to telehealth, including the use of home spirometry in cystic fibrosis. Evaluating the accuracy and precision of longitudinal home spirometry is a requisite for telehealth-based research. This secondary analysis of a CF study (eICE) evaluates whether there are cross-sectional or longitudinal differences between home and clinic spirometry.METHODS:
Participants age ≥14 years with ppFEV1>25 were recruited from 2011-2015, issued a home spirometer, and asked to complete spirometry efforts twice per week for one year. Clinic spirometry was collected at baseline and every three months. Cross-sectional differences between clinic spirometry and the closest home spirometry measurement were analyzed. Longitudinally, we apply 5 methods to analyze the precision of home spirometry, and differences between clinic vs. home data.RESULTS:
Home spirometry is estimated to be 2.0 (95% CI 0.3, 3.5) percentage points lower than clinic spirometry cross-sectionally. Longitudinally, the estimates of 12-month change in home spirometry varied by analysis method from -2.6 to -1.0 ppFEV1/ year, with precision markedly different. However, home spirometry change estimates were qualitatively similar to the clinicresults:
-3.0 ppFEV1/year (95% CI -4.1, -1.9).CONCLUSIONS:
To leverage the potential cost, feasibility and convenience of home spirometry, the differences with clinic spirometry must be acknowledged. Significantly lower ppFEV1 in home devices shows that direct comparison to clinic spirometers may induce a spurious change from baseline, and additional variability in home devices impacts statistical power. The effect of coaching, setting, and equipment must be understood to use and improve home spirometry in CF.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Spirometry
/
Telemedicine
/
Cystic Fibrosis
Type of study:
Cohort study
/
Experimental Studies
/
Observational study
/
Prognostic study
/
Qualitative research
/
Randomized controlled trials
Limits:
Adolescent
/
Adult
/
Female
/
Humans
/
Male
/
Young adult
Language:
English
Journal:
J Cyst Fibros
Year:
2022
Document Type:
Article
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