» Articles » PMID: 37244842

Quantifying Variation in Home Spirometry in People with Cystic Fibrosis During Baseline Health, and Associations with Clinical Outcomes

Overview
Journal J Cyst Fibros
Publisher Elsevier
Specialty Pulmonary Medicine
Date 2023 May 27
PMID 37244842
Authors
Affiliations
Soon will be listed here.
Abstract

Background: Home spirometry is increasingly used to monitor lung function in people with cystic fibrosis (pwCF). Although decreases in lung function in the setting of increased respiratory symptoms are consistent with a pulmonary exacerbation (PEx), the interpretation of home spirometry during asymptomatic periods of baseline health is unclear. The aims of this study were to determine the variation in home spirometry in pwCF during asymptomatic periods of baseline health and to identify associations between this variation and PEx.

Methods: Near-daily home spirometry measurements were obtained from a cohort of pwCF enrolled in a long-term study of the airway microbiome. Associations between the degree of variation in home spirometry and the time to next PEx were evaluated.

Results: Thirteen subjects (mean age of 29 years and mean percent predicted forced expiratory volume in one second [ppFEV] of 60) provided a median of 204 spirometry readings taken during 40 periods of baseline health. The mean week-to-week within-subject level of variation in ppFEV was 15.2 ± 6.2%. The degree of variation in ppFEV during baseline health was not associated with time to PEx.

Conclusions: Variation in ppFEV measured with near-daily home spirometry in pwCF during periods of baseline health exceeded the variation in ppFEV expected in clinic spirometry (based on ATS guidelines). The degree of variation in ppFEV during baseline health was not associated with time to PEx. These data are relevant for guiding interpretation of home spirometry.

Citing Articles

Baseline-dependent improvement in CF studies, plausibility of bias.

Graham E, Heltshe S, Magaret A Contemp Clin Trials Commun. 2024; 42:101378.

PMID: 39678155 PMC: 11639362. DOI: 10.1016/j.conctc.2024.101378.


Accuracy, Reproducibility, and Responsiveness to Treatment of Home Spirometry in Cystic Fibrosis: Multicenter, Retrospective, Observational Study.

Oppelaar M, van Helvoort H, Bannier M, Reijers M, van der Vaart H, van der Meer R J Med Internet Res. 2024; 26:e60892.

PMID: 39626236 PMC: 11653036. DOI: 10.2196/60892.


Impact of day-to-day variation in FEV1 on measures of change: A conceptual description.

Magaret A, Graham E, Caverly L, Cromwell E, Paynter A, Rosenfeld M J Cyst Fibros. 2024; 23(5):943-946.

PMID: 39147620 PMC: 11410506. DOI: 10.1016/j.jcf.2024.07.005.


Cystic fibrosis year in review 2023.

Swetland D, Savant A Pediatr Pulmonol. 2024; 59(12):3106-3116.

PMID: 39056532 PMC: 11601032. DOI: 10.1002/ppul.27190.


Microbial community organization designates distinct pulmonary exacerbation types and predicts treatment outcome in cystic fibrosis.

Widder S, Carmody L, Opron K, Kalikin L, Caverly L, LiPuma J Nat Commun. 2024; 15(1):4889.

PMID: 38849369 PMC: 11161516. DOI: 10.1038/s41467-024-49150-y.


References
1.
Goss C, Burns J . Exacerbations in cystic fibrosis. 1: Epidemiology and pathogenesis. Thorax. 2007; 62(4):360-7. PMC: 2092469. DOI: 10.1136/thx.2006.060889. View

2.
Compton M, List R, Starheim E, Somerville L, Williamson L, Murray R . Home spirometry utilisation in telemedicine clinic for cystic fibrosis care during COVID-19 pandemic: a quality improvement process. BMJ Open Qual. 2021; 10(3). PMC: 8390143. DOI: 10.1136/bmjoq-2021-001529. View

3.
Lechtzin N, Mayer-Hamblett N, West N, Allgood S, Wilhelm E, Khan U . Home Monitoring of Patients with Cystic Fibrosis to Identify and Treat Acute Pulmonary Exacerbations. eICE Study Results. Am J Respir Crit Care Med. 2017; 196(9):1144-1151. PMC: 5694835. DOI: 10.1164/rccm.201610-2172OC. View

4.
Rondeau V, Commenges D, Joly P . Maximum penalized likelihood estimation in a gamma-frailty model. Lifetime Data Anal. 2003; 9(2):139-53. PMC: 1961627. DOI: 10.1023/a:1022978802021. View

5.
Pellegrino R, Viegi G, Brusasco V, Crapo R, Burgos F, Casaburi R . Interpretative strategies for lung function tests. Eur Respir J. 2005; 26(5):948-68. DOI: 10.1183/09031936.05.00035205. View