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Feasibility and Measurement Quality of Home-Based Smartphone Spirometry in Children With Suspected Asthma: A
Antonia Knopek1, Hanna Fabinyi2, Viktoria Zach2
1Department of Pediatrics and Adolescent Medicine, Division of Pediatric Cardiology and Intensive Care Medicine, University Hospital Goettingen, Goettingen, Germany.
Insights
Smartphone spirometry is feasible for diagnosing childhood asthma at home. While compliance and quality were moderate, automated grading closely matched manual review, supporting its clinical use.
Area of Science:
- Pediatric Pulmonology
- Digital Health Technologies
- Asthma Diagnostics
Background:
- Diagnosing asthma in children is challenging due to intermittent symptoms and limited in-clinic testing.
- Smartphone spirometry offers a promising solution for at-home, repeated lung function measurements.
- Feasibility data for smartphone spirometry in children with suspected asthma are scarce.
Purpose of the Study:
- Evaluate compliance and measurement quality of smartphone spirometry in children with suspected asthma.
- Assess agreement between manual and automated grading of spirometry data.
- Identify factors influencing compliance and quality.
Main Methods:
- A multicentre prospective study involving 102 children (5-16 years) with suspected asthma.
- Participants performed daily smartphone spirometry for 7 days.
- Measurement quality assessed via ATS/ERS 2019 criteria (manual and automated grading).
Main Results:
- 93.1% performed at least one home measurement; 31.7% completed all 7 days.
- Clinically usable quality achieved by 61.7% (manual) and 74.5% (automated).
- Automated grading showed high agreement with manual review (ICC=0.90) but slightly overestimated quality.
Conclusions:
- Smartphone spirometry is feasible for home-based asthma assessment in children.
- Moderate compliance and acceptable measurement quality support clinical interpretation.
- Automated grading is reliable but potential discrepancies require clinical consideration.
Background:
Diagnosing asthma in children is challenging due to the episodic nature of symptoms and limitations of in-clinic lung function testing. Smartphone spirometry offers a potential solution by enabling repeated measurements in real-life settings. However, data on its feasibility in children with suspected but unconfirmed asthma are limited.
Objective:
To evaluate compliance, measurement quality, and agreement between manual and automated grading of smartphone spirometry in children with suspected asthma.
Methods:
In this multicentre, prospective study, 102 children aged 5-16 years with suspected asthma received a smartphone spirometer and were instructed to perform daily spirometry for 7 days. Measurement quality was assessed using ATS/ERS 2019 criteria by both manual review and automated device grading. Associations with age, supervision, and social factors were analysed.
Results:
Of 101 children with technically valid data, 93.1% performed at least one measurement series at home, while 31.7% completed measurements on all seven study days. Clinically usable measurement quality (grades A-C for both FEV1 and FVC) was achieved at least once by 61.7% (manual grading) and 74.5% (automated grading). Automated grading showed strong correlation and high agreement with manual grading (ICC = 0.90), but slightly overestimated quality. Measurement quality was not significantly associated with age, supervision, or social factors.
Conclusion:
Smartphone spirometry is feasible for home-based lung function assessment in children with suspected asthma. Compliance and measurement quality were moderate but acceptable for clinical interpretation in most participants. Automated grading aligns well with manual review though potential discrepancies should be considered in clinical decision-making.
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