Observer variability of lung function measurements in 2-6-yr-old children.

Area of Science:

• Pediatric Pulmonology
• Respiratory Physiology
• Medical Device Evaluation

Background:

• Accurate lung function measurement is crucial for diagnosing and managing pediatric respiratory diseases.
• Young children present unique challenges for pulmonary function testing due to cooperation and technique sensitivity.

Purpose of the Study:

• To evaluate the within-observer and between-observer variability of different lung function measurement techniques in children aged 2-6 years.
• To compare the reliability of impulse oscillation technique (IOT), interrupter technique (Rint), and whole body plethysmography (WBP) in a pediatric cohort.

Main Methods:

• Twenty-two asthmatic children (2-6 years) underwent independent lung function assessments by two observers.
• Measurements included respiratory resistance (Rrs,5) and reactance (Xrs,5) by IOT, specific airway resistance (sRaw) by WBP, and respiratory resistance by Rint.
• Duplicate measurements were obtained for each technique to assess within- and between-observer variability.

Main Results:

• Within-subject variability was comparable between observers for all tested methods.
• Between-observer variability was significantly higher for respiratory resistance by Rint compared to IOT and WBP.
• Systematic differences between observers were statistically significant for Xrs,5, sRaw, and Rrs,5, but not for Rint.

Conclusions:

• Lung function measurements in young children, particularly specific airway resistance and those obtained by Rint, are influenced by the observer.
• The interrupter technique demonstrates substantial between-observer variability, necessitating careful consideration in clinical and research settings.
• Future evaluations of novel pediatric lung function testing methods should prioritize assessing between-observer variability.