Work

COMPAIR: a comparison of directly supervised clinic versus virtually supervised home spirometry

Year: 2025

Type: article

Abstract: 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 (FEV 1 ) 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 FEV 1 (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 (FEV 1 : 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.

Source: ERJ Open Research

DOI: 10.1183/23120541.01130-2024