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      Use of the forced-oscillation technique to estimate spirometry values

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          Spirometry is sometimes difficult to perform in elderly patients and in those with severe respiratory distress. The forced-oscillation technique (FOT) is a simple and noninvasive method of measuring respiratory impedance. The aim of this study was to determine if FOT data reflect spirometric indices.

          Patients and methods

          Patients underwent both FOT and spirometry procedures prior to inclusion in development (n=1,089) and validation (n=552) studies. Multivariate linear regression analysis was performed to identify FOT parameters predictive of vital capacity (VC), forced VC (FVC), and forced expiratory volume in 1 second (FEV 1). A regression equation was used to calculate estimated VC, FVC, and FEV 1. We then determined whether the estimated data reflected spirometric indices. Agreement between actual and estimated spirometry data was assessed by Bland–Altman analysis.


          Significant correlations were observed between actual and estimated VC, FVC, and FEV 1 values (all r>0.8 and P<0.001). These results were deemed robust by a separate validation study (all r>0.8 and P<0.001). Bias between the actual data and estimated data for VC, FVC, and FEV 1 in the development study was 0.007 L (95% limits of agreement [LOA] 0.907 and −0.893 L), −0.064 L (95% LOA 0.843 and −0.971 L), and −0.039 L (95% LOA 0.735 and −0.814 L), respectively. On the other hand, bias between the actual data and estimated data for VC, FVC, and FEV 1 in the validation study was −0.201 L (95% LOA 0.62 and −1.022 L), −0.262 L (95% LOA 0.582 and −1.106 L), and −0.174 L (95% LOA 0.576 and −0.923 L), respectively, suggesting that the estimated data in the validation study did not have high accuracy.


          Further studies are needed to generate more accurate regression equations for spirometric indices based on FOT measurements.

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          Most cited references 23

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          ATS/ERS/WASOG statement on sarcoidosis. American Thoracic Society/European Respiratory Society/World Association of Sarcoidosis and other Granulomatous Disorders.

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            The forced oscillation technique in clinical practice: methodology, recommendations and future developments.

             ,  K Desager,  E Oostveen (2003)
            The forced oscillation technique (FOT) is a noninvasive method with which to measure respiratory mechanics. FOT employs small-amplitude pressure oscillations superimposed on the normal breathing and therefore has the advantage over conventional lung function techniques that it does not require the performance of respiratory manoeuvres. The present European Respiratory Society Task Force Report describes the basic principle of the technique and gives guidelines for the application and interpretation of FOT as a routine lung function test in the clinical setting, for both adult and paediatric populations. FOT data, especially those measured at the lower frequencies, are sensitive to airway obstruction, but do not discriminate between obstructive and restrictive lung disorders. There is no consensus regarding the sensitivity of FOT for bronchodilation testing in adults. Values of respiratory resistance have proved sensitive to bronchodilation in children, although the reported cutoff levels remain to be confirmed in future studies. Forced oscillation technique is a reliable method in the assessment of bronchial hyperresponsiveness in adults and children. Moreover, in contrast with spirometry where a deep inspiration is needed, forced oscillation technique does not modify the airway smooth muscle tone. Forced oscillation technique has been shown to be as sensitive as spirometry in detecting impairments of lung function due to smoking or exposure to occupational hazards. Together with the minimal requirement for the subject's cooperation, this makes forced oscillation technique an ideal lung function test for epidemiological and field studies. Novel applications of forced oscillation technique in the clinical setting include the monitoring of respiratory mechanics during mechanical ventilation and sleep.
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              Impulse oscillometry: interpretation and practical applications.

              Simple spirometry and body plethysmography have been routinely used in children aged > 5 years. New techniques based on physiologic concepts that were first described almost 50 years ago are emerging in research and in clinical practice for measuring pulmonary function in children. These techniques have led to an increased understanding of the pediatric lung and respiratory mechanics. Impulse oscillometry (IOS), a simple, noninvasive method using the forced oscillation technique, requires minimal patient cooperation and is suitable for use in both children and adults. This method can be used to assess obstruction in the large and small peripheral airways and has been used to measure bronchodilator response and bronchoprovocation testing. New data suggest that IOS may be useful in predicting loss of asthma control in the pediatric population. This article reviews the clinical applications of IOS, with an emphasis on the pediatric setting, and discusses appropriate coding practices for the clinician.

                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
                03 October 2017
                : 12
                : 2859-2868
                [1 ]Department of Cardiology, Pulmonology, Hypertension, and Nephrology
                [2 ]Department of Cardiovascular and Thoracic Surgery, Ehime University Graduate School of Medicine, Toon
                [3 ]Department of Internal Medicine, Sumitomo Besshi Hospital, Niihama, Japan
                Author notes
                Correspondence: Seigo Miyoshi, Department of Cardiology, Pulmonology, Hypertension, and Nephrology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime 791-0295, Japan, Tel +81 89 960 5303, Fax +81 89 960 5306, Email seigom@
                © 2017 Yamamoto 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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