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SpiroPlay: a study to evaluate gamified spirometry in asthmatic children

With, A.J.V. de (2022) SpiroPlay: a study to evaluate gamified spirometry in asthmatic children.

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Abstract:Rationale: Asthma is the most common chronic disease in childhood and it imposes a significant burden on the child and its family. Regular monitoring of asthma control, however, results in a reduction of asthma symptoms and an improvement of the quality of life. Spirometry is a physiological test that provides paediatricians with objective lung function data and it can be used as a (home) monitoring tool. Spirometry and children, however, is a challenging combination as spirometry requires maximal effort and patient cooperation to achieve an accurate result. It is hypothesized that an attractive game with spirometry metaphors and personalized feedback and feedforward (SpiroPlay) will positively impact the quality and adherence of home spirometry in asthmatic children. Objectives: The objectives of this study were to evaluate the performance of SpiroPlay spirometry (SPS) in comparison to Gold Standard spirometry (GSS) and to evaluate the effect of different spirometry metaphors on spirometry performance. Methods: In this prospective, multi-centre, cross-over study, 30 asthmatic children aged 6-11 years performed two consecutive spirometry sessions in random order: one session of SPS and one session of GSS. All spirometry sessions were performed in a hospital setting with the AirNext spirometer of Nuvoair and according to the ATS/ERS guidelines. The forced expiratory volume in 0.5 seconds (FEV0.5), forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), forced expiratory time (FET), peak expiratory flow (PEF), mean forced expiratory flow between 25% and 75% of FVC (FEF2575) and the amount and type of errors were registered and used for comparison. Spirometry errors were registered manually by the healthcare professional and automatically by an error detection algorithm. Results: A comparison of the lung function parameter outcomes between SPS and GSS showed that the FEF2575 was significantly higher (p < 0.01) and the FET was significantly lower (p = 0.05) during SPS. No significant differences were found regarding the other lung function parameter outcomes. An individual analysis of the FEV1 showed that 86 – 95% of the children were able to attain reproducible measurements between GSS and SPS. A comparison of the amount of errors between GSS and SPS showed no significant differences. In addition, an evaluation of the effect of different spirometry metaphors on spirometry performance showed no significant differences in terms of lung function parameter outcomes and the increase in the amount of errors compared to GSS. Conclusion: With SpiroPlay children are able to maintain a high quality of lung function measurements, making it a very promising tool for home spirometry. Future studies are needed to evaluate the quality and adherence over time, investigate whether tailoring can be used to improve spirometry technique and determine the impact of SpiroPlay on clinical outcomes such as asthma control.
Item Type:Essay (Master)
Faculty:TNW: Science and Technology
Subject:44 medicine, 50 technical science in general, 54 computer science
Programme:Technical Medicine MSc (60033)
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