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Reliability of the Breathing Pattern Assessment Tool for Remote Assessment in People With COPD
Pedro Freitas1, Cristina Jácome2, Rui Vilarinho1,3
1FP-I3ID, FP-BHS, Escola Superior de Saúde Fernando Pessoa, Porto, Portugal.
Background And Purpose:
Assessing breathing patterns in people with chronic obstructive pulmonary disease (COPD) is essential, yet assessment tools are often inaccessible outside of specialized care. The Brompton Breathing Pattern Assessment Tool (BPAT) enables quick, contactless evaluations, making it suitable for remote assessments. Although the BPAT has been shown to be reliable for remote evaluation of asthma patients, there is no evidence regarding its reliability for COPD patients. The aim of this study was to assess the reliability of the BPAT for remote assessment in patients with chronic obstructive pulmonary disease (COPD).
Methods:
This cross-sectional study included 18 adults with medically confirmed stable COPD (mean age 80 ± 8.3 years; 72.2% female). One physiotherapist conducted in-person BPAT evaluations, while a high-definition smartphone camera and microphone captured video of the participants' full upper bodies. Three physiotherapists participated as remote assessors, independently evaluating the same recorded breathing patterns. The main outcome measure was the total scores from the BPAT. The intraclass correlation coefficient (ICC3,1) was used to assess inter-rater reliability, and Bland-Altman analyses were conducted between the in-person assessor and each remote assessor.
Results:
The reliability of the BPAT was positive and moderate between the four assessors (ICC 0.70 [0.50-0.86]) and the three remote assessors (ICC 0.70 [0.47-0.86]). The mean differences from the Bland-Altman analyses ranged from -1.17 to -0.22 points.
Discussion:
This study demonstrates that the BPAT seems to be reliable for remote use in people with COPD and may serve as a useful screening instrument to identify individuals who could benefit from further specialist assessment of breathing pattern disorders.
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