Validity of a portable spirometer in the communities of China

Disease Burden, Treatment Patterns and Asthma Control in Adult Patients with Asthma in China: A Real-World Study

Purpose

To inform better asthma management in China, this study aimed to comprehensively investigate clinical characteristics, treatment patterns, asthma control status, exacerbations, and humanistic burden among adult patients seeking hospital-based asthma care by analyzing data from Adelphi Asthma Disease Specific Program conducted in China.

Patients and Methods

All information was collected on survey date (August-December 2018) from medical records, physicians, or patients, without follow-up being conducted. Results are summarized descriptively for the overall population as well as subgroups defined by GINA 2018 treatment step.

Results

Of the included 765 patients, 46.0%, 40.4%, and 29.2% had undergone lung function, blood eosinophil count, and specific immunoglobulin E/radioallergosorbent testing, and 17.2%, 24.1%, and 58.7% were managed at GINA Steps 1-2, 3, and 4-5, respectively. Asthma was not well controlled in 57.3% of patients based on definitions adapted from the ERS/ATS and 10.7% of patients had experienced ≥1 severe exacerbation in the preceding year. According to patient self-reporting (n=603), the mean (SD) was 0.9 (0.1) for utility on EQ-5D-3L and was 7.8% (10.4%), 36.9% (20.0%), 40.8% (22.2%), and 37.9% (22.3%) for absenteeism, presenteeism, work productivity loss, and activity impairment, respectively, on WPAI. Both asthma control and humanistic burden worsened with progressive GINA treatment steps.

Conclusion

In patients seeking hospital-based asthma care in China, lung function and biomarker tests were underutilized, impairment in productivity and quality of life was observed, and more than half did not achieve well-controlled asthma despite approximately 60% being managed at GINA treatment Steps 4-5. These findings highlight the urgent need for optimizing asthma management in China.

Design and Evaluation of a Novel Venturi-Based Spirometer for Home Respiratory Monitoring

The high cost and limited availability of home spirometers pose a significant barrier to effective respiratory disease management and monitoring. To address this challenge, this paper introduces a novel Venturi-based spirometer designed for home use, leveraging the Bernoulli principle. The device features a 3D-printed Venturi tube that narrows to create a pressure differential, which is measured by a differential pressure sensor and converted into airflow rate. The airflow is then integrated over time to calculate parameters such as the Forced Vital Capacity (FVC) and Forced Expiratory Volume in one second (FEV1). The system also includes a bacterial filter for hygienic use and a circuit board for data acquisition and streaming. Evaluation with eight healthy individuals demonstrated excellent test-retest reliability, with intraclass correlation coefficients (ICCs) of 0.955 for FVC and 0.853 for FEV1. Furthermore, when compared to standard Pulmonary Function Test (PFT) equipment, the spirometer exhibited strong correlation, with Pearson correlation coefficients of 0.992 for FVC and 0.968 for FEV1, and high reliability, with ICCs of 0.987 for FVC and 0.907 for FEV1. These findings suggest that the Venturi-based spirometer could significantly enhance access to spirometry at home. However, further large-scale validation and reliability studies are necessary to confirm its efficacy and reliability for widespread use.

Estimating the global prevalence of chronic obstructive pulmonary disease (COPD): a systematic review and meta-analysis

BACKGROUND

Chronic obstructive pulmonary disease (COPD) is a major public health problem. The present study aims to provide a global and regional estimate of the prevalence of COPD based on spirometry according to the two most widely used diagnostic criteria of COPD: fixed ratio (FR) and lower limit of normal (LLN).

METHODS

We conducted a systematic review of the literature according to PRISMA guidelines. MEDLINE, Web of Sciences, and Scopus databases were searched to identify studies on the spirometry-based prevalence of COPD in individuals aged 40 years and older. The meta-analysis was performed using MedCalc 19 software.

RESULTS

In total, 42 of the 3393 studies reviewed were eligible for inclusion. The overall prevalence of COPD in people aged 40 years and older was 12.64% (95% CI 10.75%-14.65%) and 7.38% (95% CI 5.47% - 9.55%) based on FR and LLN criteria, respectively. By gender, men had a higher prevalence of COPD compared to women (15.47%; 95% CI 12.22%-19.02% for men versus 8.79%; 95% CI 6.94%-10.82% for women). Using the LLN criteria, the prevalence of COPD in both sexes was almost identical (8.67%; 95% CI 8.44%- 8.90% for men and 8.00%; 95% CI 6.42% - 9.73% for women). We reported a high prevalence of COPD among smokers and the elderly by both definitions of airway obstruction. Regional prevalence estimates using the FR definition indicate that the highest COPD prevalence was recorded in the Americas and the lowest was recorded in the Eastern Mediterranean region. Using the LLN definition, the highest prevalence was recorded in the Southeast Asian region and the lowest prevalence was recorded in the American region. The most common COPD stage was stage II, with a prevalence of 50.46%. The results indicate a huge lack of prevalence data in the African and Eastern Mediterranean region. The results were given using a random-effect model due to the high heterogeneity between studies.

CONCLUSION

Results show that the prevalence of COPD differs according to the diagnostic criteria used. In addition, management and prevention strategies targeting risk factors for COPD are certainly needed to reduce the global burden of this chronic respiratory disease.