{
  "abstract": "Background Oscillometry may provide the feasible and sensitive tool for objective remote monitoring of paediatric asthma.Methods Observational study of school-aged healthy, well-controlled and poorly-controlled asthma performing daily home-based oscillometry for 3–4 months, alongside objective measures of asthma control (Asthma Control Questionnaire weekly and Asthma Control Test monthly), medication use and exacerbations. Day-to-day variability calculated as coefficient of variation (CV) for resistance at 5 Hz (R5), reactance at 5 Hz (X5) and area under reactance curve (AX). Our objective was to examine feasibility, whether day-to-day variability was increased in asthma and correlations with asthma control and exacerbation burden. Clinical exacerbation patterns were examined using principal component analysis and k-means clustering of oscillometry, symptoms, breathing parameters and adherence.Results Feasibility was 74.9±16.0% in health (n=13, 93.7±16.2 days) and 80.6±12.9% in asthma (n=42, 101.6±24.9 days; 17 well-controlled and 27 poorly-controlled asthma). Increased day-to-day variability in all oscillometry indices occurred in asthma versus health (all p≤0.002), with CV R5 the best discriminator (area under receiver operating characteristics curve 0.88, p<0.001). CV R5 increased during exacerbation and correlated with all asthma control measures and exacerbation burden. Correlations remained when examining non-exacerbation oscillometry data. Two exacerbation patterns were found based on oscillometry data in the pre-exacerbation period, characterised by severity of impairment of R5, X5, AX and CV R5 (n=12, more severe). Findings were similar using post-exacerbation period oscillometry data (n=8, more severe). Symptoms did not differ across exacerbation patterns.Conclusions Home-based oscillometry monitoring was highly feasible over extended periods in school-aged asthmatics. Day-to-day oscillometry variability was increased in asthma compared with health, reflected asthma control and exacerbation burden and identified differing exacerbation patterns.",
  "authors": [
    {
      "affiliations": [
        "University of Sydney, Sydney, New South Wales, Australia"
      ],
      "name": "Minh Trang Hoang"
    },
    {
      "affiliations": [
        "Concord Hospital, Concord, New South Wales, Australia"
      ],
      "name": "Alexander Wong"
    },
    {
      "affiliations": [
        "Respiratory Medicine, Concord Hospital, Concord, New South Wales, Australia"
      ],
      "name": "Kate Hardaker"
    },
    {
      "affiliations": [
        "University of Sydney, Sydney, New South Wales, Australia"
      ],
      "name": "Sashritha Peiris"
    },
    {
      "affiliations": [
        "Griffith Biostatistics Unit, Griffith Health, Griffith University, Queensland, Australia"
      ],
      "name": "Brett Dyer"
    },
    {
      "affiliations": [
        "Respiratory Medicine, The Children’s Hospital at Westmead, Westmead, New South Wales, Australia"
      ],
      "name": "Ediane de Queiroz Andrade"
    },
    {
      "affiliations": [
        "The Children’s Hospital at Westmead, Westmead, New South Wales, Australia"
      ],
      "name": "Anneliese Blaxland"
    },
    {
      "affiliations": [
        "Respiratory Medicine, The Children’s Hospital at Westmead, Westmead, New South Wales, Australia"
      ],
      "name": "Penny Field"
    },
    {
      "affiliations": [
        "Respiratory Medicine, The Children’s Hospital at Westmead, Westmead, New South Wales, Australia",
        "Discipline of Paediatrics and Child Health, University of Sydney, Sydney, New South Wales, Australia"
      ],
      "name": "Dominic A Fitzgerald"
    },
    {
      "affiliations": [
        "Respiratory Medicine, The Children’s Hospital at Westmead, Westmead, New South Wales, Australia"
      ],
      "name": "Geshani Jayasuriya"
    },
    {
      "affiliations": [
        "Respiratory Medicine, The Children’s Hospital at Westmead, Westmead, New South Wales, Australia"
      ],
      "name": "Chetan Pandit"
    },
    {
      "affiliations": [
        "Respiratory Medicine, The Children’s Hospital at Westmead, Westmead, New South Wales, Australia",
        "Discipline of Paediatrics and Child Health, University of Sydney, Sydney, New South Wales, Australia"
      ],
      "name": "Hiran Selvadurai"
    },
    {
      "affiliations": [
        "Respiratory Medicine, Royal North Shore Hospital, St Leonards, New South Wales, Australia",
        "The Woolcock Institute of Medical Research, Macquarie Park, New South Wales, Australia"
      ],
      "name": "Gregory G King"
    },
    {
      "affiliations": [
        "The Woolcock Institute of Medical Research, Macquarie Park, New South Wales, Australia"
      ],
      "name": "Cindy Thamrin"
    },
    {
      "affiliations": [
        "The Woolcock Institute of Medical Research, Macquarie Park, New South Wales, Australia",
        "Respiratory Medicine, Queensland Children’s Hospital, Brisbane, Queensland, Australia",
        "Children's Health and Environment Program, Child Health Research Centre, University of Queensland, Brisbane, Queensland, Australia"
      ],
      "name": "Paul D Robinson"
    }
  ],
  "title": "Day-to-day variability indices improve utility of oscillometry in paediatric asthma",
  "uid": "d0969e26-a323-5412-9f20-1cb3bb54bd94"
}