{
  "abstract": "Introduction Spirometry is routinely used to assess patients with suspected or confirmed airway disease. However, it has been criticised for its potential insensitivity in detecting early or mild airways disease and some patients struggle to meet the required technical standards. The use of the Forced Oscillation Technique (FOT) has been proposed to address these concerns but remains relatively unused in clinical practice. This service level evaluation aimed to assess the potential benefits of incorporating FOT into routine spirometry testing within a respiratory physiology outpatient service.Methods Patients referred for spirometry ± reversibility testing at Hampshire Hospitals NHS Foundation Trust were also assessed using FOT (ResMon Pro Full V3). Abnormal spirometry (FEV1/VCmax z-score <-1.64), abnormal FOT parameters (total resistance; Rrs at 5 Hz > upper limit of normal and/or reactance; Xrs at 5 < lower limit of normal) and a positive bronchodilator response (BD; >200 mL AND 12% for FEV1; −32% for Rrs 5 Hz and/or +44% for Xrs 5) were defined accordingly.Results Anonymised data for 119 patients who attended clinic between April 2023 and June 2024 were analysed and grouped as follows; normal spirometry and normal FOT (n=56), abnormal spirometry and abnormal FOT (n=23), normal spirometry but abnormal FOT (n=10), and abnormal spirometry but normal FOT (n=30). Reversibility testing was performed in 19 patients. Of these, six had a positive BD response on spirometry but only one also demonstrated a positive BD response on FOT. One patient demonstrated a positive BD response on FOT but a negative response on spirometry.Conclusions Unexpectedly, 57% of patients with airflow obstruction on spirometry had normal FOT results (total Rrs and Xrs at 5 Hz) and only 17% of patients with a positive BD response on spirometry demonstrated a positive response on FOT. These preliminary findings suggest that if performed as an alternative to spirometry, FOT may fail to identify abnormalities in patients with potential airflow obstruction. Further analysis will be carried out to classify the severity of airflow obstruction, assess additional FOT parameters including within-breath abnormalities, and attempt to understand the discrepancies seen in this evaluation between the two tests.",
  "authors": [
    {
      "affiliations": [
        "Hampshire Hospitals NHS Foundation Trust, Basingstoke, UK"
      ],
      "name": "Madison Geeves"
    },
    {
      "affiliations": [
        "Hampshire Hospitals NHS Foundation Trust, Basingstoke, UK"
      ],
      "name": "Michael Hughes"
    },
    {
      "affiliations": [
        "Curtin University, Perth, Australia"
      ],
      "name": "Phoebe Wan"
    },
    {
      "affiliations": [
        "Hampshire Hospitals NHS Foundation Trust, Basingstoke, UK"
      ],
      "name": "Elise Mercer"
    },
    {
      "affiliations": [
        "Hampshire Hospitals NHS Foundation Trust, Basingstoke, UK"
      ],
      "name": "Megan Leonard"
    },
    {
      "affiliations": [
        "Hampshire Hospitals NHS Foundation Trust, Basingstoke, UK"
      ],
      "name": "Zoe Ford"
    },
    {
      "affiliations": [
        "Hampshire Hospitals NHS Foundation Trust, Basingstoke, UK"
      ],
      "name": "Harry Griffin"
    }
  ],
  "title": "P59 Implementation of the forced oscillation technique into spirometry clinics: a service level evaluation",
  "uid": "351db9de-d7d1-599d-91d9-ee7e7eea93ac"
}