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      The accuracy of a handheld “disposable pneumotachograph device” in the spirometric diagnosis of airway obstruction in a Chinese population

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          Background and aim

          It is desirable to facilitate the use of an affordable, reliable, and portable spirometer, for earlier diagnosis of COPD in China, particularly in rural areas. The aim of this study was to assess the agreement of a handheld “disposable pneumotachograph” (D-PNEU) spirometer with the gold standard spirometer and to evaluate its diagnostic accuracy of spirometric classification of airflow obstruction.

          Subjects and methods

          A total of 241 adult Chinese subjects ranging from healthy to those with mixed levels of pulmonary disease performed spirometry in a conventional body plethysmograph, and using a D-PNEU device in randomized order. The three best spirometric tests were recorded for comparative analysis. A Bland–Altman graph was created to assess the agreement between devices. Using FEV 1/FVC <70% as the “gold standard” for obstruction, the accuracy of classifying the severity of airway obstruction for all subjects was assessed. For the specific individuals (n=159) able to exhale for at least 6 seconds, the accuracy of classifying airway obstruction was further assessed. For this purpose, a receiver operating characteristic curve was used to determine an optimal cutoff point of FEV 1/FEV 6 ratio obtained by the D-PNEU device, which matched the global definition of FEV 1/FVC <70% by the traditional spirometer.


          The Bland–Altman analysis showed that the between-device agreement for key airflow metrics was within clinically acceptable limits. The D-PNEU device had 87.1% accuracy in the classification of severity of obstruction in all 241 subjects, when using FEV 1/FVC<70% as the “gold standard” for both devices. The D-PNEU device had 93.7% accuracy in the 159 individuals able to exhale for at least 6 seconds, when a cutoff point of FEV 1/FEV 6 was 74%.


          A disposable handheld spirometry device is capable of accurately identifying and quantifying airway obstruction in patients deemed to be at risk, however, caution should be exercised and all available brands should be tested.

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          Most cited references 20

          • Record: found
          • Abstract: found
          • Article: not found

          Statistical methods for assessing agreement between two methods of clinical measurement.

          In clinical measurement comparison of a new measurement technique with an established one is often needed to see whether they agree sufficiently for the new to replace the old. Such investigations are often analysed inappropriately, notably by using correlation coefficients. The use of correlation is misleading. An alternative approach, based on graphical techniques and simple calculations, is described, together with the relation between this analysis and the assessment of repeatability.
            • Record: found
            • Abstract: not found
            • Article: not found

            Tips for learners of evidence-based medicine: 3. Measures of observer variability (kappa statistic).

             T. McGinn (2004)
              • Record: found
              • Abstract: found
              • Article: not found

              COPD in China

              Although, to our knowledge, there has been no exhaustive or credible review of the evidence of the disease burden of COPD in China, COPD has become an increasing public health concern to the Chinese medical community. The purpose of this article is to review the evidence and evaluate and clarify the disease burden of COPD in China with the aim of improving effective management. We reviewed previous studies of COPD in China, which included data on prevalence, mortality, disease burden, risk factors, diagnosis, and management by searching related Web sites, including PubMed, ProQuest, and Thomson Reuters' Web of Knowledge, as well as major Chinese databases and government Web sites. Reported COPD prevalence varied between 5% and 13% in different provinces/cities across China. In 2008, COPD ranked fourth as a leading cause of death in urban areas and third in rural areas. In addition, COPD accounted for 1.6% of all hospital admissions in China in that year. The high prevalence of smoking and biomass fuel use acted as major contributors to the high occurrence of COPD in China. Management of COPD in China should focus on adjusting the distribution of medical resources and on addressing public health policies to facilitate earlier diagnosis in rural areas, aim to reduce smoking prevalence, improve patients' self-management, and keep physicians' knowledge up to date and consistent with current guidelines. COPD is one of the most challenging medical issues facing China because of its influence on both personal and public health and its impact on the economy. Optimal management strategies should be adopted and strengthened immediately.

                Author and article information

                Int J Chron Obstruct Pulmon Dis
                Int J Chron Obstruct Pulmon Dis
                International Journal of COPD
                International Journal of Chronic Obstructive Pulmonary Disease
                Dove Medical Press
                02 August 2018
                : 13
                : 2351-2360
                [1 ]Department of Emergency Medicine, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China, fangxsh@
                [2 ]Department of Respiratory Medicine, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
                [3 ]Zhang Neuroscience Research Laboratories, School of Medicine, Loma Linda University, Loma Linda, CA, USA
                [4 ]Bioengineering Department, Gordon and Jill Bourns College of Engineering, California Baptist University, Riverside, CA, USA
                Author notes
                Correspondence: Xiangshao Fang, Department of Emergency Medicine, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yan Jiang Xi Road, Guangzhou 510120, China, Tel +86 20 8133 2084, Email fangxsh@

                These authors contributed equally to this work

                © 2018 Chen et al. This work is published and licensed by Dove Medical Press Limited

                The full terms of this license are available at and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.

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