Within-session reproducibility of forced oscillometry

Abstract

Background: The forced oscillation technique (FOT) provides detailed information about the mechanics of the respiratory system, while requiring minimal co-operation by the patient. FOT may be abnormal in subjects with normal spirometry and appears to be more closely related to airway symptoms. It is, therefore, attractive in epidemiological studies, where a large number of different examinations are made in each subjects in a short period of time. Current technical standards recommend the mean of three consecutive measurements to be used, but there is limited information regarding within-session variability of FOT measurements.

Objective: The purpose of this study was to examine the within-session variability in FOT measurements in a large, population-based sample.

Methods: We performed three consecutive FOT measurements in 700 subjects using the impulse oscillometry system. The first measurement was compared to the mean of three measurements for resistance at 5 and 20 Hz (R5 and R20, respectively), R5-R20, reactance at 5 Hz (X5) and resonant frequency (f_res ).

Results: The differences between the first and the mean of three measurements (median, interquartile range) were minimal, for example 0.002, -0.008 to 0.014 kPa L^-1 s for R5 and -0.001, -0.008 to 0.005 kPa L^-1 s for X5. Findings were numerically similar for men and women as well as for subjects with and without airflow obstruction at spirometry.

Conclusions: We conclude that, whereas in clinical situations, three FOT measurements are to be preferred, a single measurement may suffice in epidemiological studies.

Keywords: chronic obstructive pulmonary disease; epidemiology; forced oscillometry; pulmonary function tests; within-session variability.