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Updated: Sep 18, 2025
Conducting Respiratory Oscillometry in an Outpatient Setting
Published on: April 8, 2022
Day-to-day variability indices improve utility of oscillometry in paediatric asthma
Minh Trang Hoang1, Alexander Wong2, Kate Hardaker3
1University of Sydney, Sydney, New South Wales, Australia.
Insights
Home-based oscillometry monitoring is feasible for children with asthma. Increased day-to-day variability in oscillometry measurements reflects poor asthma control and exacerbation burden, aiding in pattern identification.
Area of Science:
- Pediatric Pulmonology
- Respiratory Medicine
- Biomedical Engineering
Background:
- Oscillometry offers a potential method for objective, remote monitoring of pediatric asthma.
- Current monitoring methods may lack sensitivity for detecting subtle changes in asthma control.
Purpose of the Study:
- To assess the feasibility of home-based oscillometry in school-aged children.
- To determine if day-to-day oscillometry variability differs between healthy children and those with asthma.
- To correlate oscillometry variability with asthma control and exacerbation burden.
Main Methods:
- An observational study involving healthy children and children with well-controlled and poorly-controlled asthma.
- Daily home-based oscillometry (R5, X5, AX) for 3-4 months.
- Objective asthma control measures (Asthma Control Questionnaire, Asthma Control Test), medication use, and exacerbations were recorded.
- Day-to-day variability calculated as coefficient of variation (CV).
- Principal component analysis and k-means clustering used to examine exacerbation patterns.
Main Results:
- High feasibility (74.9% in healthy, 80.6% in asthma) for home-based oscillometry.
- Significantly increased day-to-day variability in all oscillometry indices in children with asthma compared to healthy children (p≤0.002).
- Coefficient of variation for resistance at 5 Hz (CV R5) was the best discriminator between groups (AUC 0.88, p<0.001).
- CV R5 correlated with asthma control measures and exacerbation burden, even during non-exacerbation periods.
- Two distinct oscillometry-defined exacerbation patterns were identified.
Conclusions:
- Home-based oscillometry is a feasible and sensitive tool for extended monitoring in school-aged children with asthma.
- Increased day-to-day oscillometry variability is a key indicator of asthma control status and exacerbation risk.
- Oscillometry can differentiate exacerbation patterns, offering insights into disease management.
Background:
Oscillometry may provide the feasible and sensitive tool for objective remote monitoring of paediatric asthma.
Methods:
Observational study of school-aged healthy, well-controlled and poorly-controlled asthma performing daily home-based oscillometry for 3-4 months, alongside objective measures of asthma control (Asthma Control Questionnaire weekly and Asthma Control Test monthly), medication use and exacerbations. Day-to-day variability calculated as coefficient of variation (CV) for resistance at 5 Hz (R5), reactance at 5 Hz (X5) and area under reactance curve (AX). Our objective was to examine feasibility, whether day-to-day variability was increased in asthma and correlations with asthma control and exacerbation burden. Clinical exacerbation patterns were examined using principal component analysis and k-means clustering of oscillometry, symptoms, breathing parameters and adherence.
Results:
Feasibility was 74.9±16.0% in health (n=13, 93.7±16.2 days) and 80.6±12.9% in asthma (n=42, 101.6±24.9 days; 17 well-controlled and 27 poorly-controlled asthma). Increased day-to-day variability in all oscillometry indices occurred in asthma versus health (all p≤0.002), with CV R5 the best discriminator (area under receiver operating characteristics curve 0.88, p<0.001). CV R5 increased during exacerbation and correlated with all asthma control measures and exacerbation burden. Correlations remained when examining non-exacerbation oscillometry data. Two exacerbation patterns were found based on oscillometry data in the pre-exacerbation period, characterised by severity of impairment of R5, X5, AX and CV R5 (n=12, more severe). Findings were similar using post-exacerbation period oscillometry data (n=8, more severe). Symptoms did not differ across exacerbation patterns.
Conclusions:
Home-based oscillometry monitoring was highly feasible over extended periods in school-aged asthmatics. Day-to-day oscillometry variability was increased in asthma compared with health, reflected asthma control and exacerbation burden and identified differing exacerbation patterns.
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