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. 2021 Jan;56(1):105-112.
doi: 10.1002/ppul.25119. Epub 2020 Oct 29.

Multiple breath washout quality control in the clinical setting

Bettina S Frauchiger  1 , Julia Carlens  1   2 , Andreas Herger  3 , Alexander Moeller  3 , Philipp Latzin  1 , Kathryn A Ramsey  1
Affiliations
Free article

Multiple breath washout quality control in the clinical setting

Bettina S Frauchiger et al. Pediatr Pulmonol. 2021 Jan.
Free article

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 the implementation of real-time QC in Bern, only 58% of clinical MBW tests were deemed acceptable following retrospective QC by an experienced reviewer. After the implementation of real-time QC, MBW test acceptability improved to 75% in Bern. In Zurich, after the 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.

Keywords: children; cystic fibrosis; lung clearance index; multiple breath washout; quality control.

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References

REFERENCES

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