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Multiple breath washout quality control in the clinical setting


Frauchiger, Bettina S; Carlens, Julia; Herger, Andreas; Moeller, Alexander; Latzin, Philipp; Ramsey, Kathryn A (2021). Multiple breath washout quality control in the clinical setting. Pediatric Pulmonology, 56(1):105-112.

Abstract

BACKGROUND

Multiple breath washout (MBW) is increasingly used in the clinical assessment of patients with cystic fibrosis (CF). Guidelines for MBW quality control (QC) were developed primarily for retrospective assessment and central overreading. We assessed whether real-time QC of MBW data during the measurement improves test acceptability in the clinical setting.

METHODS

We implemented standardized real-time QC and reporting of MBW data at the time of the measurement in the clinical pediatric lung function laboratory in Bern, Switzerland in children with CF aged 4-18 years. We assessed MBW test acceptability before (31 tests; 89 trials) and after (32 tests; 96 trials) implementation of real-time QC and compared agreement between reviewers. Further, we assessed the implementation of real-time QC at a secondary center in Zurich, Switzerland.

RESULTS

Before implementation of real-time QC in Bern, only 58% of clinical MBW tests were deemed acceptable following retrospective QC by an experienced reviewer. After implementation of real-time QC, MBW test acceptability improved to 75% in Bern. In Zurich, after implementation of real-time QC, test acceptability improved from 38% to 70%. Further, the agreement between MBW operators and an experienced reviewer for test acceptability was 84% in Bern and 93% in Zurich.

CONCLUSION

Real-time QC of MBW data at the time of measurement is feasible in the clinical setting and results in improved test acceptability. This article is protected by copyright. All rights reserved.

Abstract

BACKGROUND

Multiple breath washout (MBW) is increasingly used in the clinical assessment of patients with cystic fibrosis (CF). Guidelines for MBW quality control (QC) were developed primarily for retrospective assessment and central overreading. We assessed whether real-time QC of MBW data during the measurement improves test acceptability in the clinical setting.

METHODS

We implemented standardized real-time QC and reporting of MBW data at the time of the measurement in the clinical pediatric lung function laboratory in Bern, Switzerland in children with CF aged 4-18 years. We assessed MBW test acceptability before (31 tests; 89 trials) and after (32 tests; 96 trials) implementation of real-time QC and compared agreement between reviewers. Further, we assessed the implementation of real-time QC at a secondary center in Zurich, Switzerland.

RESULTS

Before implementation of real-time QC in Bern, only 58% of clinical MBW tests were deemed acceptable following retrospective QC by an experienced reviewer. After implementation of real-time QC, MBW test acceptability improved to 75% in Bern. In Zurich, after implementation of real-time QC, test acceptability improved from 38% to 70%. Further, the agreement between MBW operators and an experienced reviewer for test acceptability was 84% in Bern and 93% in Zurich.

CONCLUSION

Real-time QC of MBW data at the time of measurement is feasible in the clinical setting and results in improved test acceptability. This article is protected by copyright. All rights reserved.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Children's Hospital Zurich > Medical Clinic
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:January 2021
Deposited On:30 Oct 2020 12:46
Last Modified:15 Dec 2020 02:07
Publisher:Wiley-Blackwell Publishing, Inc.
ISSN:1099-0496
OA Status:Closed
Publisher DOI:https://doi.org/10.1002/ppul.25119
PubMed ID:33058570

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Embargo till: 2021-10-15