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Conducting Respiratory Oscillometry in an Outpatient Setting
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Reference equations for oscillometry and their differences among populations: a systematic scoping review.

Andy Deprato1, Giovanni Ferrara2, Mohit Bhutani2

  • 1Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, AB, Canada.

European Respiratory Review : an Official Journal of the European Respiratory Society
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Summary

Respiratory oscillometry shows promise for detecting airway obstructions but requires standardized reference values. This review found significant differences between existing oscillometry equations, highlighting the need for validation to prevent diagnostic errors.

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Area of Science:

  • Pulmonary Medicine
  • Diagnostic Tools
  • Respiratory Physiology

Background:

  • Respiratory oscillometry offers superior sensitivity for detecting small airway obstructions compared to traditional pulmonary function tests.
  • Clinical adoption of oscillometry is hindered by the absence of globally accepted reference values.
  • Significant heterogeneity exists among current oscillometry reference equations, potentially impacting diagnostic accuracy.

Purpose of the Study:

  • To systematically assess and quantify the heterogeneity between different oscillometric reference equations for healthy adults.
  • To compare various oscillometry reference models against a standard Caucasian model.
  • To identify variations that could lead to diagnostic errors in clinical practice.

Main Methods:

  • Systematic scoping review adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
  • Inclusion of studies developing reference equations for healthy adult populations.
  • Statistical comparison using Bland-Altman and Lin's concordance correlation analyses against a standard Caucasian model.

Main Results:

  • Ten studies were included after screening 1202 titles and abstracts.
  • Three models showed low-to-moderate agreement with the reference, especially those from non-Caucasian populations.
  • Six models demonstrated moderate-to-high agreement, but significant sex-specific variations persisted.

Conclusions:

  • This study provides the first systematic analysis of heterogeneity among oscillometric reference models.
  • Significant variations exist between equations, particularly concerning population demographics and sex.
  • Validation of appropriate oscillometry reference equations is crucial for accurate clinical application and avoiding diagnostic errors.