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Berresheim H, Beine A, van Kampen V, Lehnert M, Nöllenheidt C, Brüning T, Hoffmeyer F. ATS/ ERS spirometry quality criteria in real life. Results of two occupational field studies. Respir Physiol Neurobiol 2023:104094. [PMID: 37391004 DOI: 10.1016/j.resp.2023.104094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 06/05/2023] [Accepted: 06/15/2023] [Indexed: 07/02/2023]
Abstract
Spirometry is a widely used test and the American Thoracic Society and the European Respiratory Society (ATS/ERS) provide standardised recommendations. However, detailed information on test quality is often incomplete in publications. In light of the 2005 ATS/ERS recommendations, we investigated the acceptability and repeatability criteria of spirometry performed under occupational field conditions in 242 practicing welders (WELDOX study, median age 41.5 years, all male) and 312 first-year veterinary students (AllergoVet study, median age 20.0 years, 84.3% female). At least three acceptable or usable measurements could be identified for 233 welders and 305 students. The repeatability for welders was 96.1% for the forced expiratory volume in the first second (FEV1) and 97.0% for forced vital capacity (FVC). The corresponding results for students were 95.7% and 95.4%, respectively. The overall repeatability of test sessions at the 150-mL level was 90.5% (219/242) for welders and 90.1% (281/312) for students. Spirometry can be performed with reliable quality in an occupational field setting.
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Affiliation(s)
- Hans Berresheim
- Institute for Prevention and Occupational Medicine of the German Social Accident, 44789 Bochum, Germany; Insurance, Institute of the Ruhr-Universität Bochum (IPA), Bürkle-de-la-Camp-Platz 1, 44789 Bochum, Germany
| | - Alexandra Beine
- Institute for Prevention and Occupational Medicine of the German Social Accident, 44789 Bochum, Germany; Insurance, Institute of the Ruhr-Universität Bochum (IPA), Bürkle-de-la-Camp-Platz 1, 44789 Bochum, Germany
| | - Vera van Kampen
- Institute for Prevention and Occupational Medicine of the German Social Accident, 44789 Bochum, Germany; Insurance, Institute of the Ruhr-Universität Bochum (IPA), Bürkle-de-la-Camp-Platz 1, 44789 Bochum, Germany
| | - Martin Lehnert
- Institute for Prevention and Occupational Medicine of the German Social Accident, 44789 Bochum, Germany; Insurance, Institute of the Ruhr-Universität Bochum (IPA), Bürkle-de-la-Camp-Platz 1, 44789 Bochum, Germany
| | - Christoph Nöllenheidt
- Institute for Prevention and Occupational Medicine of the German Social Accident, 44789 Bochum, Germany; Insurance, Institute of the Ruhr-Universität Bochum (IPA), Bürkle-de-la-Camp-Platz 1, 44789 Bochum, Germany
| | - Thomas Brüning
- Institute for Prevention and Occupational Medicine of the German Social Accident, 44789 Bochum, Germany; Insurance, Institute of the Ruhr-Universität Bochum (IPA), Bürkle-de-la-Camp-Platz 1, 44789 Bochum, Germany
| | - Frank Hoffmeyer
- Institute for Prevention and Occupational Medicine of the German Social Accident, 44789 Bochum, Germany; Insurance, Institute of the Ruhr-Universität Bochum (IPA), Bürkle-de-la-Camp-Platz 1, 44789 Bochum, Germany.
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Krabbe J, Kotro AK, Kraus T. Effects of repetition as training and incentives on the performance in pulmonary function tests in healthy volunteers. Heliyon 2023; 9:e17594. [PMID: 37408925 PMCID: PMC10319240 DOI: 10.1016/j.heliyon.2023.e17594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 06/21/2023] [Accepted: 06/21/2023] [Indexed: 07/07/2023] Open
Abstract
Pulmonary function testing (PFT) is a central part of diagnosis and treatment monitoring in respiratory medicine. Few studies have investigated whether repeated PFT or training can significantly influence performance. To investigate potential training effects of repeated PFT, 30 healthy volunteers underwent daily and weekly repeated PFT with spirometry over 10 weeks. The study included 22 females and 8 males with a mean age of 31.8 years ± 15 (SD), a mean weight of 66.3 kg ± 14.5 (SD) and a mean BMI of 22.4 ± 3.3 (SD). The first 5 PFTs were performed on 5 consecutive days, followed by 3 PFTs once a week on the same day of the week. Subsequently, 5 measurements were taken daily for 5 consecutive days. After these 13 appointments in 5 weeks, participants were randomly assigned to the control or incentive group, with stratification for age and gender. The incentive group had the opportunity to win money (200 €) for the highest increase in forced vital capacity (FVC). PFTs were performed once a week on the same day of the week as before for 5 more times. Motivation was assessed by a questionnaire before the 1st, 9th and 18th measure of PFT at three time points throughout the study. An increase in PFT was observed with mean increases of 473 [ml] in FVC, 395 [ml] in forced expiratory volume in 1 s (FEV1) and 1.382 [litres/second] in peak expiratory flow (PEF) after four days of daily PFT. These increases did not persist and spirometric data returned to baseline after one week. After allocation, participants in the incentive group did not increase their FVC, FEV1 or PEF compared to the control group. The incentive group showed higher motivation than the control group, even before allocation. Repeated daily PFT could induce short-term increases, but PFT does not fluctuate significantly in the long term. External influences that affect motivation could not consistently increase PFT. For clinical practice, it can be concluded that PFT does not necessarily require extended training to ensure reliability if reproducibility criteria are met.
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Affiliation(s)
- Julia Krabbe
- Corresponding author. Institute of Occupational, Social and Environmental Medicine, Medical Faculty, RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Germany.
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Agarwal D, Hanafi NS, Khoo EM, Parker RA, Ghorpade D, Salvi S, Abu Bakar AI, Chinna K, Das D, Habib M, Hussein N, Isaac R, Islam MS, Khan MS, Liew SM, Pang YK, Paul B, Saha SK, Wong LP, Yusuf OM, Yusuf SO, Juvekar S, Pinnock H. Predictors for detecting chronic respiratory diseases in community surveys: A pilot cross-sectional survey in four South and South East Asian low- and middle-income countries. J Glob Health 2021; 11:04065. [PMID: 34737865 PMCID: PMC8561335 DOI: 10.7189/jogh.11.04065] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Background Our previous scoping review revealed limitations and inconsistencies in population surveys of chronic respiratory disease. Informed by this review, we piloted a cross-sectional survey of adults in four South/South-East Asian low-and middle-income countries (LMICs) to assess survey feasibility and identify variables that predicted asthma or chronic obstructive pulmonary disease (COPD). Methods We administered relevant translations of the BOLD-1 questionnaire with additional questions from ECRHS-II, performed spirometry and arranged specialist clinical review for a sub-group to confirm the diagnosis. Using random sampling, we piloted a community-based survey at five sites in four LMICs and noted any practical barriers to conducting the survey. Three clinicians independently used information from questionnaires, spirometry and specialist reviews, and reached consensus on a clinical diagnosis. We used lasso regression to identify variables that predicted the clinical diagnoses and attempted to develop an algorithm for detecting asthma and COPD. Results Of 508 participants, 55.9% reported one or more chronic respiratory symptoms. The prevalence of asthma was 16.3%; COPD 4.5%; and ‘other chronic respiratory disease’ 3.0%. Based on consensus categorisation (n = 483 complete records), “Wheezing in last 12 months” and “Waking up with a feeling of tightness” were the strongest predictors for asthma. For COPD, age and spirometry results were the strongest predictors. Practical challenges included logistics (participant recruitment; researcher safety); misinterpretation of questions due to local dialects; and assuring quality spirometry in the field. Conclusion Detecting asthma in population surveys relies on symptoms and history. In contrast, spirometry and age were the best predictors of COPD. Logistical, language and spirometry-related challenges need to be addressed.
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Affiliation(s)
- Dhiraj Agarwal
- Vadu Rural Health Program, KEM Hospital Research Centre (KEMHRC), Pune, India
| | | | - Ee Ming Khoo
- Faculty of Medicine, University of Malaya (UM), Kuala Lumpur, Malaysia
| | - Richard A Parker
- Edinburgh Clinical Trials Unit, Usher Institute, The University of Edinburgh, Edinburgh, UK
| | - Deesha Ghorpade
- Pulmocare Research and Education (PURE) Foundation, Pune, India
| | - Sundeep Salvi
- Pulmocare Research and Education (PURE) Foundation, Pune, India
| | | | - Karuthan Chinna
- School of Medicine, Taylor's University, Subang Jaya, Malaysia
| | - Deepa Das
- Christian Medical College (CMC), Vellore, India
| | - Monsur Habib
- Bangladesh Primary Care Respiratory Society (BPCRS), Khulna, Bangladesh
| | - Norita Hussein
- Faculty of Medicine, University of Malaya (UM), Kuala Lumpur, Malaysia
| | - Rita Isaac
- Christian Medical College (CMC), Vellore, India
| | | | | | - Su May Liew
- Faculty of Medicine, University of Malaya (UM), Kuala Lumpur, Malaysia
| | - Yong Kek Pang
- Faculty of Medicine, University of Malaya (UM), Kuala Lumpur, Malaysia
| | | | - Samir K Saha
- Child Health Research Foundation (CHRF), Dhaka, Bangladesh
| | - Li Ping Wong
- Faculty of Medicine, University of Malaya (UM), Kuala Lumpur, Malaysia
| | - Osman M Yusuf
- The Allergy & Asthma Institute (AAI), Islamabad, Pakistan
| | | | - Sanjay Juvekar
- Vadu Rural Health Program, KEM Hospital Research Centre (KEMHRC), Pune, India
| | - Hilary Pinnock
- NIHR Global Health Research Unit on Respiratory Health (RESPIRE), Usher Institute, The University of Edinburgh, Edinburgh, UK
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Lin E, Lin CH, Lane HY. Precision Psychiatry Applications with Pharmacogenomics: Artificial Intelligence and Machine Learning Approaches. Int J Mol Sci 2020; 21:ijms21030969. [PMID: 32024055 PMCID: PMC7037937 DOI: 10.3390/ijms21030969] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 01/25/2020] [Accepted: 01/30/2020] [Indexed: 12/22/2022] Open
Abstract
A growing body of evidence now suggests that precision psychiatry, an interdisciplinary field of psychiatry, precision medicine, and pharmacogenomics, serves as an indispensable foundation of medical practices by offering the accurate medication with the accurate dose at the accurate time to patients with psychiatric disorders. In light of the latest advancements in artificial intelligence and machine learning techniques, numerous biomarkers and genetic loci associated with psychiatric diseases and relevant treatments are being discovered in precision psychiatry research by employing neuroimaging and multi-omics. In this review, we focus on the latest developments for precision psychiatry research using artificial intelligence and machine learning approaches, such as deep learning and neural network algorithms, together with multi-omics and neuroimaging data. Firstly, we review precision psychiatry and pharmacogenomics studies that leverage various artificial intelligence and machine learning techniques to assess treatment prediction, prognosis prediction, diagnosis prediction, and the detection of potential biomarkers. In addition, we describe potential biomarkers and genetic loci that have been discovered to be associated with psychiatric diseases and relevant treatments. Moreover, we outline the limitations in regard to the previous precision psychiatry and pharmacogenomics studies. Finally, we present a discussion of directions and challenges for future research.
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Affiliation(s)
- Eugene Lin
- Department of Biostatistics, University of Washington, Seattle, WA 98195, USA;
- Department of Electrical & Computer Engineering, University of Washington, Seattle, WA 98195, USA
- Graduate Institute of Biomedical Sciences, China Medical University, Taichung 40402, Taiwan
| | - Chieh-Hsin Lin
- Graduate Institute of Biomedical Sciences, China Medical University, Taichung 40402, Taiwan
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan
- School of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
- Correspondence: (C.-H.L.); (H.-Y.L.)
| | - Hsien-Yuan Lane
- Graduate Institute of Biomedical Sciences, China Medical University, Taichung 40402, Taiwan
- Department of Psychiatry, China Medical University Hospital, Taichung 40402, Taiwan
- Brain Disease Research Center, China Medical University Hospital, Taichung 40402, Taiwan
- Department of Psychology, College of Medical and Health Sciences, Asia University, Taichung 41354, Taiwan
- Correspondence: (C.-H.L.); (H.-Y.L.)
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Li F, Huang ZW, Wang XF, Xu HW, Yu H, Chen YB, Huang JA, Wang JJ, Lei W. Safety and use of pulmonary function tests: a retrospective study from a single center over seven years' clinical practice. BMC Pulm Med 2019; 19:259. [PMID: 31864318 PMCID: PMC6925499 DOI: 10.1186/s12890-019-1019-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 12/04/2019] [Indexed: 03/05/2023] Open
Abstract
Background To promote the utilization of pulmonary function tests (PFT) through analyzing the data of PFT during the past seven years in one large teaching hospital in China. Methods Through a retrospective analysis, the allocation of full-time staff in PFT room, the demographic characteristics of patients, cost-effectiveness of PFT, positive rate and failure rate of PFT, adverse events were analyzed. Results 1) From 2012 to 2018, the numbers of PFT showed the trend of escalation year by year. The proportion of patients receiving PFT rose from 29.0/10,000 in 2012 to 34.7/10,000 in 2018. The best allocation of PFT room was 20–25/ person / day. 2) The number of PFT provided by Department of Pulmonary and Critical Care Medicine (PCCM) accounted for 97.2, 97.1, 97.3, 97.8, 97.8, 98.0, and 98.2% of the total cases of outpatient PFT in the same year. The top three departments in the inpatient department were Department of Thoracic Surgery, Department of General Surgery, and Department of Urinary Surgery, the total cases of PFT in these three departments accounted for 65.1, 64.4, 62.1, 63.5, 62.4, 65.3 and 69.1% of the total cases of inpatient PFT in the same year. 3) Data from 2018 showed that the revenue from PFT was about 3.7 million Chinese Yuan, and that the salary of personnel and expenditure on machine maintenance and wear were about 800,000 Chinese Yuan. 4) 58.2% of the patients who had undergone PFT had ventilatory dysfunction. 5) The average failure rate of PFT in the past seven years was 1.91%. 6) The main adverse events of PFT examination were dizziness, amaurosis, limb numbness, lip numbness and falls. The incidence rates were 0.49, 0.42, 0.41, 0.39, 0.44, 0.48, and 0.45% respectively, with an average of 0.44%. Conclusions The number of PFT showed an upward trend in the past seven years, and the optimal staffing of PFT room was 20–25 cases per person per day. The positive rate of pulmonary dysfunction was 58.2%. The failure rate of PFT and the incidence of adverse events were very low, suggesting it is a simple and safe clinical examination. It’s worthy of further popularization and promotion.
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Affiliation(s)
- Fei Li
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Soochow University, Suzhou, 215006, Jiangsu, China
| | - Zhi-Wen Huang
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Soochow University, Suzhou, 215006, Jiangsu, China.,Department of Respiratory Medicine, Affiliated Renhe Hospital of China Three Gorges University, Yichang, 443001, Hubei, China
| | - Xiao-Fei Wang
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Soochow University, Suzhou, 215006, Jiangsu, China
| | - Hui-Wen Xu
- Department of Surgery, Cancer Control, University of Rochester School of Medicine and Dentistry, Rochester, NY, 14642, USA
| | - Hua Yu
- Department of Respiratory Medicine, First People's Hospital of Fuzhou, Fuzhou, 344000, Jiangxi, China
| | - Yan-Bin Chen
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Soochow University, Suzhou, 215006, Jiangsu, China
| | - Jian-An Huang
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Soochow University, Suzhou, 215006, Jiangsu, China
| | - Jia-Jia Wang
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Soochow University, Suzhou, 215006, Jiangsu, China
| | - Wei Lei
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Soochow University, Suzhou, 215006, Jiangsu, China.
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Machine Learning in Neural Networks. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2019; 1192:127-137. [DOI: 10.1007/978-981-32-9721-0_7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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