title: Pulmonary function electronic monitoring devices: a randomized agreement study.
abstract: OBJECTIVE
  To compare in a clinical setting the within-session reproducibility of two pulmonary function electronic monitoring devices (PiKo-1; Ferraris Respiratory Europe; Hereford, UK; and Spirotel; MIR; Rome, Italy) with one mechanical device (Mini-Wright Peak-Flow Meter; Clement-Clarke International; Harlow, Essex, UK), and to evaluate the accuracy of these devices using as reference an office pneumotachograph.
  
  
  METHODS
  After detailed instructions, adults without airways diseases and patients with stable asthma attending an outpatient clinic performed four sets of expiratory maneuvers, one set for each device, in a strictly random order. Each set comprised three maneuvers with 2 to 3 min of rest between them.
  
  
  METHODS
  Reproducibility of FEV1 and peak expiratory flow (PEF) was assessed by a coefficient of variation (CV) and intraclass correlation coefficient (ICC), and accuracy was assessed by ICC and limits of agreement.
  
  
  RESULTS
  Of the 38 participants evaluated, 71% were women and 61% had asthma. Ages ranged from 18 to 58 years, and FEV1 ranged from 1.2 to 4.8 L. In all monitoring devices, CV was < 6% and ICC was > 0.94 for the reproducibility of both FEV1 and PEF measurements. The accuracy of the PiKo-1 device was better for FEV1 (ICC = 0.98) than for PEF (ICC = 0.90). The Spirotel device had similar results for FEV1 and PEF (ICC = 0.95). The Mini-Wright device had the lowest accuracy (ICC = 0.87), particularly for PEF values < 500 L/min.
  
  
  CONCLUSIONS
  These low-cost and easy-to-use electronic monitoring devices showed a very good reproducibility and were in agreement with the pneumotachograph. Therefore, the PiKo-1 and Spirotel devices seem adequate for both screening and monitoring. However, prospective studies are still needed to assess their long-term reproducibility and usability and, particularly, the effects on the improvement of respiratory care.
authors.affiliation: Imunoallergology Division, São João Hospital, Porto, Portugal. jfonseca@med.up.pt
authors.forename: Joao A
authors.initials: JA
authors.lastname: Fonseca
authors.forename: Altamiro
authors.initials: A
authors.lastname: Costa-Pereira
authors.forename: Luis
authors.initials: L
authors.lastname: Delgado
authors.forename: Luis N
authors.initials: LN
authors.lastname: Silva
authors.forename: Manuel
authors.initials: M
authors.lastname: Magalhães
authors.forename: M Graca
authors.initials: MG
authors.lastname: Castel-Branco
authors.forename: Marianela
authors.initials: M
authors.lastname: Vaz
mesh_terms: D000293:Adolescent; D000328:Adult; D001249:Asthma / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000295:instrumentation*; D015203:Reproducibility of Results; D012129:Respiratory Function Tests / Q000295:instrumentation*