Multiple breath washout quality control in the clinical setting

Area of Science:

• Pulmonary Medicine
• Pediatric Respiratory Health
• Diagnostic Technologies

Background:

• Multiple breath washout (MBW) is a key clinical tool for assessing cystic fibrosis (CF) patients.
• Existing MBW quality control (QC) guidelines focus on retrospective analysis, potentially limiting real-time clinical utility.
• The need for improved, in-procedure QC methods for MBW testing in clinical settings is recognized.

Purpose of the Study:

• To evaluate the impact of implementing real-time quality control (QC) during multiple breath washout (MBW) measurements.
• To determine if real-time QC enhances the acceptability of MBW tests in a pediatric CF population.
• To assess the feasibility and effectiveness of real-time QC in a clinical pediatric lung function laboratory.

Main Methods:

• Standardized real-time QC and reporting of MBW data were implemented in a pediatric lung function lab.
• MBW test acceptability was compared before and after real-time QC implementation in Bern, Switzerland.
• The study included children with CF aged 4-18 years and assessed inter-reviewer agreement for test acceptability.

Main Results:

• MBW test acceptability in Bern improved from 58% to 75% after implementing real-time QC.
• In Zurich, test acceptability increased from 38% to 70% following the introduction of real-time QC.
• High agreement (84-93%) was observed between MBW operators and experienced reviewers for test acceptability.

Conclusions:

• Real-time quality control (QC) of multiple breath washout (MBW) data is feasible and effective in clinical practice.
• Implementing real-time QC significantly improves the acceptability and reliability of MBW tests for pediatric CF patients.
• This approach supports more accurate and efficient clinical assessments in pediatric respiratory medicine.