Assessment of a peak flow whistle in nonasthmatic children

Area of Science:

• Pediatric Pulmonology
• Respiratory Physiology

Background:

• Peak expiratory flow (PEF) is a key metric in respiratory health assessment.
• Accurate PEF measurement is crucial for monitoring lung function in children.
• Various devices exist for PEF measurement, each with potential differences in accuracy and user engagement.

Purpose of the Study:

• To evaluate the agreement between an electronic spirometer and a peak flow whistle (Whistle Watch) for measuring peak expiratory flow in children.
• To determine if the audible feedback from the whistle influences PEF readings.
• To assess the reliability of the Whistle Watch for pediatric PEF assessment.

Main Methods:

• 103 healthy children aged 6-13 years without prior lung function testing experience participated.
• Sequential PEF readings were obtained using both an electronic spirometer (PEF(SPIRO)) and a Whistle Watch.
• The highest reproducible reading from three attempts was recorded for the spirometer; the highest activated whistle sound value was recorded for the Whistle Watch.

Main Results:

• A strong correlation (r = 0.91; R2 = 83%) was observed between spirometer and Whistle Watch readings.
• However, a significant lack of agreement was found between the two devices.
• 64% of children achieved higher PEF values with the Whistle Watch, with a 95% probability interval of +30.4 to -47 L/min.

Conclusions:

• The audible incentive of the Whistle Watch likely led to greater maximal expiratory efforts, inflating readings compared to the spirometer.
• While correlated, the Whistle Watch and spirometer do not demonstrate interchangeable agreement for PEF measurement in this pediatric cohort.
• The findings suggest that the whistle's sound acts as a significant motivator, impacting maximal expiratory effort measurement.