Novel App-Based Portable Spirometer for the Early Detection of COPD
Journal
Diagnostics (Basel, Switzerland)
Journal Volume
11
Journal Issue
5
Date Issued
2021-04-27
Author(s)
Lin, Ching-Hsiung
Cheng, Shih-Lung
Hsu, Wu-Huei
Lee, Kang-Yun
Perng, Diahn-Warng
Lin, Hen-I
Lin, Ming-Shian
Tsai, Jong-Rung
Wang, Chin-Chou
Lin, Sheng-Hao
Wang, Cheng-Yi
Chen, Chiung-Zuei
Yang, Tsung-Ming
Liu, Ching-Lung
Wang, Tsai-Yu
Lin, Meng-Chih
Abstract
Chronic obstructive pulmonary disease (COPD) is preventable and treatable. However, many patients remain undiagnosed and untreated due to the underutilization or unavailability of spirometers. Accordingly, we used Spirobank Smart, an app-based spirometer, for facilitating the early detection of COPD in outpatient clinics. This prospective study recruited individuals who were at risk of COPD (i.e., with age of ≥40 years, ≥10 pack-years of smoking, and at least one respiratory symptoms) but had no previous COPD diagnosis. Eligible participants were examined with Spirobank Smart and then underwent confirmatory spirometry (performed using a diagnostic spirometer), regardless of their Spirobank Smart test results. COPD was defined and confirmed using the postbronchodilator forced expiratory volume in 1 s/forced vital capacity values of <0.70 as measured by confirmatory spirometry. A total of 767 participants were enrolled and examined using Spirobank Smart; 370 participants (94.3% men, mean age of 60.9 years and mean 42.6 pack-years of smoking) underwent confirmatory spirometry. Confirmatory spirometry identified COPD in 103 participants (27.8%). At the optimal cutoff point of 0.74 that was determined using Spirobank Smart for COPD diagnosis, the area under the receiver operating characteristic was 0.903 (95% confidence interval (CI) = 0.860-0.947). Multivariate logistic regression revealed that participants who have an FEV1/FVC ratio of <74% that was determined using Spirobank Smart (odds ratio (OR) = 58.58, 95% CI = 27.29-125.75) and old age (OR = 3.23, 95% CI = 1.04-10.07 for 60 ≤ age < 65; OR = 5.82, 95% CI = 2.22-15.27 for age ≥ 65) had a higher risk of COPD. The Spirobank Smart is a simple and adequate tool for early COPD detection in outpatient clinics. Early diagnosis and appropriate therapy based on GOLD guidelines can positively influence respiratory symptoms and quality of life.
Subjects
COPD; app-based spirometer; early detection; underdiagnosis
SDGs
Other Subjects
bronchodilating agent; adult; aged; Article; body mass; bronchodilatation; chronic obstructive lung disease; controlled study; disease severity; early diagnosis; female; forced expiratory volume; forced vital capacity; human; lung function; major clinical study; male; middle aged; mobile application; multicenter study; outpatient department; predictive value; prospective study; quality of life; receiver operating characteristic; reference value; respiratory tract disease; sensitivity and specificity; smoking; spirometry; validation study
Type
journal article