Diagnostic value of spirometry vs impulse oscillometry: A comparative study in children with sickle cell disease

Pritish Mondal, Alison Yirinec, Vishal Midya, Binu John Sankoorikal, Gayle Smink, Arshjot Khokhar, Mutasim Abu-Hasan, Rebecca Bascom

Research output: Contribution to journalArticle

Abstract

Background: Spirometry is conventionally used to diagnose airway diseases in children with sickle cell disease (C-SCD). However, spirometry is difficult for younger children to perform, is effort dependent, and it provides limited information on respiratory mechanics. Impulse oscillometry (IOS) is an effort-independent pulmonary function test (PFT), which measures total airway resistance (R5Hz) and reactance (AX). IOS could be advantageous without certain limitations of spirometry. Aim: To compare the accuracy of IOS vs spirometry in making the diagnosis of asthma and assessing age-related pulmonary changes in C-SCD. Study design: Retrospective chart review. Subject selection: Fifty-six C-SCD and thirty-six controls (asthmatics without SCD) followed at Penn State with PFTs obtained during the initial pulmonary evaluation. Methodology: We grouped C-SCD into asthmatics and non-asthmatics based on pre-referral diagnosis and compared PFTs between two groups. Receiver operating characteristic (ROC) curve analyses and machine learning tools (XGBoost and artificial neural network) were used to rank the spirometry and IOS measures based on their ability to predict a diagnosis of asthma. Robust linear regression was used to analyze association among height/age with various PFT measures. Results: Both ROC and XGBoost indicated that FEF25-75%, forced expiratory volume in 1 second (FEV1)/forced vital capacity, and R5Hz(%) were the top three predictors for asthma diagnosis. R5Hz(%) and AX had superior bronchodilator response (BDR) than FEV1. IOS parameters had significant association with height/age in C-SCD (possibly due to the stiff lungs) but not in controls. Conclusion: IOS had advantages over spirometry in C-SCD because it is feasible in early childhood, provides insights into the pulmonary mechanics, and is more sensitive to detect BDR.

Original languageEnglish (US)
Pages (from-to)1422-1430
Number of pages9
JournalPediatric Pulmonology
Volume54
Issue number9
DOIs
StatePublished - Jan 1 2019

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Oscillometry
Spirometry
Sickle Cell Anemia
Lung
Asthma
Bronchodilator Agents
Respiratory Function Tests
Forced Expiratory Volume
ROC Curve
Respiratory Mechanics
Airway Resistance
Vital Capacity
Mechanics
Patient Selection
Linear Models
Referral and Consultation
Retrospective Studies

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health
  • Pulmonary and Respiratory Medicine

Cite this

@article{362667c0eed241938dfcb53dbaf2ae69,
title = "Diagnostic value of spirometry vs impulse oscillometry: A comparative study in children with sickle cell disease",
abstract = "Background: Spirometry is conventionally used to diagnose airway diseases in children with sickle cell disease (C-SCD). However, spirometry is difficult for younger children to perform, is effort dependent, and it provides limited information on respiratory mechanics. Impulse oscillometry (IOS) is an effort-independent pulmonary function test (PFT), which measures total airway resistance (R5Hz) and reactance (AX). IOS could be advantageous without certain limitations of spirometry. Aim: To compare the accuracy of IOS vs spirometry in making the diagnosis of asthma and assessing age-related pulmonary changes in C-SCD. Study design: Retrospective chart review. Subject selection: Fifty-six C-SCD and thirty-six controls (asthmatics without SCD) followed at Penn State with PFTs obtained during the initial pulmonary evaluation. Methodology: We grouped C-SCD into asthmatics and non-asthmatics based on pre-referral diagnosis and compared PFTs between two groups. Receiver operating characteristic (ROC) curve analyses and machine learning tools (XGBoost and artificial neural network) were used to rank the spirometry and IOS measures based on their ability to predict a diagnosis of asthma. Robust linear regression was used to analyze association among height/age with various PFT measures. Results: Both ROC and XGBoost indicated that FEF25-75{\%}, forced expiratory volume in 1 second (FEV1)/forced vital capacity, and R5Hz({\%}) were the top three predictors for asthma diagnosis. R5Hz({\%}) and AX had superior bronchodilator response (BDR) than FEV1. IOS parameters had significant association with height/age in C-SCD (possibly due to the stiff lungs) but not in controls. Conclusion: IOS had advantages over spirometry in C-SCD because it is feasible in early childhood, provides insights into the pulmonary mechanics, and is more sensitive to detect BDR.",
author = "Pritish Mondal and Alison Yirinec and Vishal Midya and Sankoorikal, {Binu John} and Gayle Smink and Arshjot Khokhar and Mutasim Abu-Hasan and Rebecca Bascom",
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Diagnostic value of spirometry vs impulse oscillometry : A comparative study in children with sickle cell disease. / Mondal, Pritish; Yirinec, Alison; Midya, Vishal; Sankoorikal, Binu John; Smink, Gayle; Khokhar, Arshjot; Abu-Hasan, Mutasim; Bascom, Rebecca.

In: Pediatric Pulmonology, Vol. 54, No. 9, 01.01.2019, p. 1422-1430.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Diagnostic value of spirometry vs impulse oscillometry

T2 - A comparative study in children with sickle cell disease

AU - Mondal, Pritish

AU - Yirinec, Alison

AU - Midya, Vishal

AU - Sankoorikal, Binu John

AU - Smink, Gayle

AU - Khokhar, Arshjot

AU - Abu-Hasan, Mutasim

AU - Bascom, Rebecca

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background: Spirometry is conventionally used to diagnose airway diseases in children with sickle cell disease (C-SCD). However, spirometry is difficult for younger children to perform, is effort dependent, and it provides limited information on respiratory mechanics. Impulse oscillometry (IOS) is an effort-independent pulmonary function test (PFT), which measures total airway resistance (R5Hz) and reactance (AX). IOS could be advantageous without certain limitations of spirometry. Aim: To compare the accuracy of IOS vs spirometry in making the diagnosis of asthma and assessing age-related pulmonary changes in C-SCD. Study design: Retrospective chart review. Subject selection: Fifty-six C-SCD and thirty-six controls (asthmatics without SCD) followed at Penn State with PFTs obtained during the initial pulmonary evaluation. Methodology: We grouped C-SCD into asthmatics and non-asthmatics based on pre-referral diagnosis and compared PFTs between two groups. Receiver operating characteristic (ROC) curve analyses and machine learning tools (XGBoost and artificial neural network) were used to rank the spirometry and IOS measures based on their ability to predict a diagnosis of asthma. Robust linear regression was used to analyze association among height/age with various PFT measures. Results: Both ROC and XGBoost indicated that FEF25-75%, forced expiratory volume in 1 second (FEV1)/forced vital capacity, and R5Hz(%) were the top three predictors for asthma diagnosis. R5Hz(%) and AX had superior bronchodilator response (BDR) than FEV1. IOS parameters had significant association with height/age in C-SCD (possibly due to the stiff lungs) but not in controls. Conclusion: IOS had advantages over spirometry in C-SCD because it is feasible in early childhood, provides insights into the pulmonary mechanics, and is more sensitive to detect BDR.

AB - Background: Spirometry is conventionally used to diagnose airway diseases in children with sickle cell disease (C-SCD). However, spirometry is difficult for younger children to perform, is effort dependent, and it provides limited information on respiratory mechanics. Impulse oscillometry (IOS) is an effort-independent pulmonary function test (PFT), which measures total airway resistance (R5Hz) and reactance (AX). IOS could be advantageous without certain limitations of spirometry. Aim: To compare the accuracy of IOS vs spirometry in making the diagnosis of asthma and assessing age-related pulmonary changes in C-SCD. Study design: Retrospective chart review. Subject selection: Fifty-six C-SCD and thirty-six controls (asthmatics without SCD) followed at Penn State with PFTs obtained during the initial pulmonary evaluation. Methodology: We grouped C-SCD into asthmatics and non-asthmatics based on pre-referral diagnosis and compared PFTs between two groups. Receiver operating characteristic (ROC) curve analyses and machine learning tools (XGBoost and artificial neural network) were used to rank the spirometry and IOS measures based on their ability to predict a diagnosis of asthma. Robust linear regression was used to analyze association among height/age with various PFT measures. Results: Both ROC and XGBoost indicated that FEF25-75%, forced expiratory volume in 1 second (FEV1)/forced vital capacity, and R5Hz(%) were the top three predictors for asthma diagnosis. R5Hz(%) and AX had superior bronchodilator response (BDR) than FEV1. IOS parameters had significant association with height/age in C-SCD (possibly due to the stiff lungs) but not in controls. Conclusion: IOS had advantages over spirometry in C-SCD because it is feasible in early childhood, provides insights into the pulmonary mechanics, and is more sensitive to detect BDR.

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