“You're on mute!” Does pediatric CF home spirometry require physiologist supervision?

Introduction The coronavirus disease 2019 (COVID‐19) pandemic has accelerated the move towards home spirometry monitoring, including in children. The aim of this study is to determine whether the remote supervision of spirometry by a physiologist improves the technical quality and failure rate of th...

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Veröffentlicht in:	Pediatric pulmonology 2022-01, Vol.57 (1), p.278-284
Hauptverfasser:	Fettes, Emma, Riley, Mollie, Brotherston, Stephanie, Doughty, Claire, Griffiths, Benjamin, Laverty, Aidan, Aurora, Paul
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Sprache:	eng
Schlagworte:	Child COVID-19 cystic fibrosis Cystic Fibrosis - diagnosis home spirometry Humans Laboratories Monitoring, Physiologic pediatrics remote monitoring SARS-CoV-2 Spirometry
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creator	Fettes, Emma Riley, Mollie Brotherston, Stephanie Doughty, Claire Griffiths, Benjamin Laverty, Aidan Aurora, Paul
description	Introduction The coronavirus disease 2019 (COVID‐19) pandemic has accelerated the move towards home spirometry monitoring, including in children. The aim of this study is to determine whether the remote supervision of spirometry by a physiologist improves the technical quality and failure rate of the maneuvers. Method Children with cystic fibrosis who had been provided with NuvoAir home spirometers were randomly allocated to either supervised or unsupervised home spirometry following a detailed training session. Home spirometry was performed every 2 weeks for 12 weeks. Tests were assigned a quality factor (QF) using our laboratory grading system as per American Thoracic Society/European Respiratory Society standards, with tests marked from A to D, or Fail. In our laboratory, we aim for QF A in all spirometry tests, but report results of QF B or C with a cautionary note. QF A was, therefore, the primary outcome, and QF A–C, the secondary outcome. Results Sixty‐one patients were enrolled; 166 measurements were obtained in the supervised group, and 153 in the unsupervised group. Significantly more measurements achieved QF A in the supervised compared to unsupervised group (89% vs. 74%; p =
doi_str_mv	10.1002/ppul.25708
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The aim of this study is to determine whether the remote supervision of spirometry by a physiologist improves the technical quality and failure rate of the maneuvers. Method Children with cystic fibrosis who had been provided with NuvoAir home spirometers were randomly allocated to either supervised or unsupervised home spirometry following a detailed training session. Home spirometry was performed every 2 weeks for 12 weeks. Tests were assigned a quality factor (QF) using our laboratory grading system as per American Thoracic Society/European Respiratory Society standards, with tests marked from A to D, or Fail. In our laboratory, we aim for QF A in all spirometry tests, but report results of QF B or C with a cautionary note. QF A was, therefore, the primary outcome, and QF A–C, the secondary outcome. Results Sixty‐one patients were enrolled; 166 measurements were obtained in the supervised group, and 153 in the unsupervised group. Significantly more measurements achieved QF A in the supervised compared to unsupervised group (89% vs. 74%; p = <0.001), while proportions reaching Grade A–C were similar (99% vs. 95%; p = 0.1). All significant declines in spirometry results had a clinical rather than technical reason. Family/patient feedback for both arms was very positive. Conclusion These results suggest that home spirometry in children should ideally be remotely supervised by a physiologist, but acceptable results can be obtained if resources do not allow this, provided that training is delivered and results monitored according to our protocol.</description><identifier>ISSN: 8755-6863</identifier><identifier>EISSN: 1099-0496</identifier><identifier>DOI: 10.1002/ppul.25708</identifier><identifier>PMID: 34581507</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>Child ; COVID-19 ; cystic fibrosis ; Cystic Fibrosis - diagnosis ; home spirometry ; Humans ; Laboratories ; Monitoring, Physiologic ; pediatrics ; remote monitoring ; SARS-CoV-2 ; Spirometry</subject><ispartof>Pediatric pulmonology, 2022-01, Vol.57 (1), p.278-284</ispartof><rights>2021 Wiley Periodicals LLC</rights><rights>2021 Wiley Periodicals LLC.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3578-83f9b640ba527d0d48e779b2dc95e9f4d7a1c244baf4ed4e3ab0678d3edb6a993</citedby><cites>FETCH-LOGICAL-c3578-83f9b640ba527d0d48e779b2dc95e9f4d7a1c244baf4ed4e3ab0678d3edb6a993</cites><orcidid>0000-0003-1463-746X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fppul.25708$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fppul.25708$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,778,782,1414,27907,27908,45557,45558</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34581507$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Fettes, Emma</creatorcontrib><creatorcontrib>Riley, Mollie</creatorcontrib><creatorcontrib>Brotherston, Stephanie</creatorcontrib><creatorcontrib>Doughty, Claire</creatorcontrib><creatorcontrib>Griffiths, Benjamin</creatorcontrib><creatorcontrib>Laverty, Aidan</creatorcontrib><creatorcontrib>Aurora, Paul</creatorcontrib><title>“You're on mute!” Does pediatric CF home spirometry require physiologist supervision?</title><title>Pediatric pulmonology</title><addtitle>Pediatr Pulmonol</addtitle><description>Introduction The coronavirus disease 2019 (COVID‐19) pandemic has accelerated the move towards home spirometry monitoring, including in children. The aim of this study is to determine whether the remote supervision of spirometry by a physiologist improves the technical quality and failure rate of the maneuvers. Method Children with cystic fibrosis who had been provided with NuvoAir home spirometers were randomly allocated to either supervised or unsupervised home spirometry following a detailed training session. Home spirometry was performed every 2 weeks for 12 weeks. Tests were assigned a quality factor (QF) using our laboratory grading system as per American Thoracic Society/European Respiratory Society standards, with tests marked from A to D, or Fail. In our laboratory, we aim for QF A in all spirometry tests, but report results of QF B or C with a cautionary note. QF A was, therefore, the primary outcome, and QF A–C, the secondary outcome. Results Sixty‐one patients were enrolled; 166 measurements were obtained in the supervised group, and 153 in the unsupervised group. Significantly more measurements achieved QF A in the supervised compared to unsupervised group (89% vs. 74%; p = <0.001), while proportions reaching Grade A–C were similar (99% vs. 95%; p = 0.1). All significant declines in spirometry results had a clinical rather than technical reason. Family/patient feedback for both arms was very positive. Conclusion These results suggest that home spirometry in children should ideally be remotely supervised by a physiologist, but acceptable results can be obtained if resources do not allow this, provided that training is delivered and results monitored according to our protocol.</description><subject>Child</subject><subject>COVID-19</subject><subject>cystic fibrosis</subject><subject>Cystic Fibrosis - diagnosis</subject><subject>home spirometry</subject><subject>Humans</subject><subject>Laboratories</subject><subject>Monitoring, Physiologic</subject><subject>pediatrics</subject><subject>remote monitoring</subject><subject>SARS-CoV-2</subject><subject>Spirometry</subject><issn>8755-6863</issn><issn>1099-0496</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kMFKHTEUhkOp1Kt24wOUKV0ohdFkkpkkKylXrcIFXdSFdBEykzM1MnMzJpOWu_NBFHwWH8UnMXrVhYuufjjnOz-HD6FNgncIxsXuMMRupyg5Fh_QhGApc8xk9RFNBC_LvBIVXUVrIVxinHaSfEKrlJWClJhP0O-H65tzF7c8ZG6e9XGErw_Xt_d3-w5CNoCxevS2yaaH2YXrIQuD9SlHv7i_83AVbbobLhbBus79sWHMQhzA_7VpMN_bQCut7gJ8fsl1dHZ48Gt6lM9Ofh5Pf8zyhpZc5IK2sq4YrnVZcIMNE8C5rAvTyBJkywzXpCkYq3XLwDCgusYVF4aCqSstJV1H28vewburCGFUvQ0NdJ2eg4tBJTWcJT2ySui3d-ili36evlNFhQWhvKA4Ud-XVONdCB5aNXjba79QBKsn5epJuXpWnuAvL5Wx7sG8oa-OE0CWwD_bweI_Ver09Gy2LH0EVbmQQg</recordid><startdate>202201</startdate><enddate>202201</enddate><creator>Fettes, Emma</creator><creator>Riley, Mollie</creator><creator>Brotherston, Stephanie</creator><creator>Doughty, Claire</creator><creator>Griffiths, Benjamin</creator><creator>Laverty, Aidan</creator><creator>Aurora, Paul</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-1463-746X</orcidid></search><sort><creationdate>202201</creationdate><title>“You're on mute!” Does pediatric CF home spirometry require physiologist supervision?</title><author>Fettes, Emma ; Riley, Mollie ; Brotherston, Stephanie ; Doughty, Claire ; Griffiths, Benjamin ; Laverty, Aidan ; Aurora, Paul</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3578-83f9b640ba527d0d48e779b2dc95e9f4d7a1c244baf4ed4e3ab0678d3edb6a993</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Child</topic><topic>COVID-19</topic><topic>cystic fibrosis</topic><topic>Cystic Fibrosis - diagnosis</topic><topic>home spirometry</topic><topic>Humans</topic><topic>Laboratories</topic><topic>Monitoring, Physiologic</topic><topic>pediatrics</topic><topic>remote monitoring</topic><topic>SARS-CoV-2</topic><topic>Spirometry</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Fettes, Emma</creatorcontrib><creatorcontrib>Riley, Mollie</creatorcontrib><creatorcontrib>Brotherston, Stephanie</creatorcontrib><creatorcontrib>Doughty, Claire</creatorcontrib><creatorcontrib>Griffiths, Benjamin</creatorcontrib><creatorcontrib>Laverty, Aidan</creatorcontrib><creatorcontrib>Aurora, Paul</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Pediatric pulmonology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Fettes, Emma</au><au>Riley, Mollie</au><au>Brotherston, Stephanie</au><au>Doughty, Claire</au><au>Griffiths, Benjamin</au><au>Laverty, Aidan</au><au>Aurora, Paul</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>“You're on mute!” Does pediatric CF home spirometry require physiologist supervision?</atitle><jtitle>Pediatric pulmonology</jtitle><addtitle>Pediatr Pulmonol</addtitle><date>2022-01</date><risdate>2022</risdate><volume>57</volume><issue>1</issue><spage>278</spage><epage>284</epage><pages>278-284</pages><issn>8755-6863</issn><eissn>1099-0496</eissn><abstract>Introduction The coronavirus disease 2019 (COVID‐19) pandemic has accelerated the move towards home spirometry monitoring, including in children. The aim of this study is to determine whether the remote supervision of spirometry by a physiologist improves the technical quality and failure rate of the maneuvers. Method Children with cystic fibrosis who had been provided with NuvoAir home spirometers were randomly allocated to either supervised or unsupervised home spirometry following a detailed training session. Home spirometry was performed every 2 weeks for 12 weeks. Tests were assigned a quality factor (QF) using our laboratory grading system as per American Thoracic Society/European Respiratory Society standards, with tests marked from A to D, or Fail. In our laboratory, we aim for QF A in all spirometry tests, but report results of QF B or C with a cautionary note. QF A was, therefore, the primary outcome, and QF A–C, the secondary outcome. Results Sixty‐one patients were enrolled; 166 measurements were obtained in the supervised group, and 153 in the unsupervised group. Significantly more measurements achieved QF A in the supervised compared to unsupervised group (89% vs. 74%; p = <0.001), while proportions reaching Grade A–C were similar (99% vs. 95%; p = 0.1). All significant declines in spirometry results had a clinical rather than technical reason. Family/patient feedback for both arms was very positive. Conclusion These results suggest that home spirometry in children should ideally be remotely supervised by a physiologist, but acceptable results can be obtained if resources do not allow this, provided that training is delivered and results monitored according to our protocol.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>34581507</pmid><doi>10.1002/ppul.25708</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0003-1463-746X</orcidid></addata></record>
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subjects	Child COVID-19 cystic fibrosis Cystic Fibrosis - diagnosis home spirometry Humans Laboratories Monitoring, Physiologic pediatrics remote monitoring SARS-CoV-2 Spirometry
title	“You're on mute!” Does pediatric CF home spirometry require physiologist supervision?
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