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dc.contributor.authorJensen, R.
dc.contributor.authorStanojevic, S.
dc.contributor.authorKlingel, M.
dc.contributor.authorPizarro, M.
dc.contributor.authorHall, Graham
dc.contributor.authorRamsey, K.
dc.contributor.authorFoong, R.
dc.contributor.authorSaunders, C.
dc.contributor.authorRobinson, P.
dc.contributor.authorWebster, H.
dc.contributor.authorHardaker, K.
dc.contributor.authorKane, M.
dc.contributor.authorRatjen, F.
dc.identifier.citationJensen, R. and Stanojevic, S. and Klingel, M. and Pizarro, M. and Hall, G. and Ramsey, K. and Foong, R. et al. 2016. A Systematic Approach to Multiple Breath Nitrogen Washout Test Quality. PLoS One. 11 (6): pp. e0157523-e0157523.

Background: Accurate estimates of multiple breath washout (MBW) outcomes require correct operation of the device, appropriate distraction of the subject to ensure they breathe in a manner representative of their relaxed tidal breathing pattern, and appropriate interpretation of the acquired data. Based on available recommendations for an acceptable MBW test, we aimed to develop a protocol to systematically evaluate MBW measurements based on these criteria. Methods: 50MBWtest occasions were systematically reviewed for technical elements and whether the breathing pattern was representative of relaxed tidal breathing by an experienced MBW operator. The impact of qualitative and quantitative criteria on inter-observer agreement was assessed across eight MBW operators (n = 20 test occasions, compared using a Kappa statistic). Results: Using qualitative criteria, 46/168 trials were rejected: 16.6%were technically unacceptable and 10.7% were excluded due to inappropriate breathing pattern. Reviewer agreement was good using qualitative criteria and further improved with quantitative criteria from (κ = 0.53– 0.83%) to (κ 0.73–0.97%), but at the cost of exclusion of further test occasions in this retrospective data analysis. Conclusions: The application of the systematic review improved inter-observer agreement but did not affect reported MBW outcomes.

dc.publisherPublic Library of Science
dc.titleA Systematic Approach to Multiple Breath Nitrogen Washout Test Quality
dc.typeJournal Article
dcterms.source.titlePLoS One
curtin.departmentSchool of Physiotherapy and Exercise Science
curtin.accessStatusOpen access

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