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COMPAIR: a comparison of directly supervised clinic versus virtually supervised home spirometry
Ashish Pradhan1, Jacqui Pollington2, Dinesh Saralaya3
1The Nottingham Asthma Centre, Nottingham City Hospital NHS Foundation Trust, Nottingham, UK.
Background:
Our objectives were to compare directly supervised in clinic spirometry (DSCS) with virtually supervised at home spirometry (VSHS), assess the utility of artificial intelligence (AI) over-reading and evaluate patients' views of VSHS.
Methods:
A multicentre, prospective, 8-day study was conducted in adult patients with physician-diagnosed asthma or COPD from UK primary/secondary care. Spirometry (forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC)) was performed using the NuvoAir Air Next Bluetooth portable spirometer supported by trained healthcare providers (HCPs) in clinic (Days 1 and 8) and virtually supervised at home (Days 2 and 7). Over-reading was done manually and by ArtiQ.QC (cloud-based AI). Inter-method concordance and agreement were assessed by correlation analyses and Bland-Altman plots, respectively. Participants completed a questionnaire (Day 8) to assess their views on VSHS.
Results:
68 participants were included (asthma: n=47; COPD: n=21). There was excellent concordance between HCP-over-read DSCS (Day 1) and VSHS (Day 2) as indicated by intraclass correlation coefficients for FEV1 (0.95 (95% CI 0.92-0.97)) and FVC (0.95 (95% CI 0.92-0.97)), which were slightly higher when over-read by ArtiQ.QC (FEV1: 0.98 (95% CI 0.97-0.99); FVC: 0.96 (95% CI 0.93-0.97)). Bland-Altman plots showed good agreement between DSCS and VSHS, for both manual and ArtiQ.QC over-read assessments, with evidence of better agreement when over-read by ArtiQ.QC. More than 95% of patients considered the NuvoAir spirometer and mobile app easy to use and would be happy to use it in the future.
Conclusions:
VSHS with the NuvoAir spirometer and ArtiQ.QC over-reading offers reliable and consistent measures of lung function for research purposes and potential clinical application in a population of patients with asthma or COPD. VSHS coupled with AI over-read allows spirometry to be performed at a more convenient location for patients while maintaining high-quality results, comparable to clinic-based spirometry.
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