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Improvement of tidal breathing pattern analysis in children with asthma by on-line automatic data processing
C K van der Ent1, H J Brackel, P Mulder
1Wilhelmina Children's Hospital, University Hospital for Children and Youth, Dept of Paediatric Pulmonology, Utrecht, The Netherlands.
The European Respiratory Journal
|June 1, 1996
Summary
Computer analysis of tidal breathing (TB) curves accurately assesses airway obstruction in children with asthma. This method, using the t PTEF/t E ratio, is more stable and reliable than manual selection, improving diagnostic applicability.
Area of Science:
- Pediatric Pulmonology
- Respiratory Physiology
- Medical Technology
Background:
- Tidal breathing (TB) analysis, specifically the time to peak tidal expiratory flow (t PTEF) as a proportion of total expiratory time (t E), is a key indicator of airway obstruction in pediatric asthma.
- Curve selection bias presents a significant limitation in accurately interpreting TB parameters.
Purpose of the Study:
- To evaluate the effectiveness of three distinct curve selection methods for TB analysis in children with asthma.
- To compare the accuracy, stability, and reliability of computer-selected, manually eye-selected, and unselected TB curves.
Main Methods:
- A computer program (Masterscreen Paediatric) was used for on-line selection and analysis of TB curves in 26 children (aged 4-7 years) with asthma.
- Measurements were taken before and after methacholine provocation and after bronchodilation.
- The study compared t PTEF/t E ratios and their stability across computer-selected, eye-selected, and unselected curves.
Main Results:
- Computer-selected t PTEF/t E ratios closely matched unbiased eye-selected curves (limits of agreement -4.8% to +5.8%) but differed significantly from unselected curves.
- Computer-derived ratios demonstrated superior stability, with a reliability coefficient of 0.96 compared to 0.84 for eye selection and 0.87 for no selection.
- Methacholine provocation significantly decreased the mean t PTEF/t E ratio (30% to 22%), which was restored after bronchodilation (30%).
Conclusions:
- On-line computer analysis of TB curves is superior to manual or no selection for assessing airflow obstruction in young children with asthma.
- This automated method effectively mitigates curve selection bias, enhancing the clinical utility of TB analysis.
- The computer program accurately assesses tidal volume, respiratory rate, and inspiratory/expiratory times, further supporting its application.