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Small-sample reproducibility estimates: an example using rebreathing measurements.

R L Jensen1, R O Crapo, J D Mason

  • 1Department of Medicine, LDS Hospital, Salt Lake City, Utah.

Journal of Applied Physiology (Bethesda, Md. : 1985)
|April 1, 1990
PubMed
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This study introduces a statistical method to assess parameter reproducibility using limited measurements. Rebreathing measurements for cardiac output and diffusing capacity show good reproducibility, while lung tissue volume requires averaging multiple readings for precision.

Area of Science:

  • Pulmonary Physiology
  • Statistical Modeling
  • Respiratory Medicine

Background:

  • Assessing the reproducibility of physiological parameters is crucial for clinical diagnostics and research.
  • Traditional methods often require multiple measurements, which may not always be feasible.

Purpose of the Study:

  • To develop and apply a statistical technique for estimating parameter reproducibility from limited (two) repeated measurements per individual.
  • To evaluate the reproducibility of acetylene cardiac output (Qc), lung tissue volume (Vti), and carbon monoxide diffusing capacity (DLCO) using rebreathing techniques.

Main Methods:

  • Analyzed data from 86 healthy subjects (51 men, 35 women) undergoing two rebreathing measurements each.
  • Utilized a computerized rebreathing system with a specific gas mixture (10% He-0.3% C18O-0.7% C2H2-25% O2-balance N2).

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  • Applied Chebyshev's inequality to estimate measurement imprecision and the impact of averaging repeated values.

    • Main Results:

    • Estimated coefficients of variation were 6.8% for Qc, 10.3% for Vti, and 5.7% for DLCO.
    • Single measurements: Qc within 14.2%, Vti within 21.7%, DLCO within 12.0% of the true mean (90% confidence).
    • Averaging three measurements improved precision: Qc to 8.2%, Vti to 12.6%, DLCO to 6.9% (90% confidence).

    Conclusions:

    • Rebreathing Qc demonstrates reproducibility comparable to other cardiac output measurement methods.
    • Rebreathing DLCO exhibits reproducibility similar to the single-breath technique.
    • Averaging two to three Vti measurements is recommended for achieving adequate precision in lung tissue volume assessment.