Abnormal Oscillometry in a Multicenter Study of Subjects Following Hematopoietic Stem Cell Transplantation (HSCT) Identified as “Normal" at Enrollment
Notice bibliographique
Résumé
Abstract Rationale: Oscillometry is a tidal breathing test which may be useful to monitor lung function and screen for early manifestations of pulmonary abnormalities after HSCT. We previously reported that oscillometry is abnormal in patients preparing to undergo HSCT. However, little is known about the sensitivity of oscillometry to identify sub-clinical abnormal pulmonary function in this population. Methods: The TRANSPIRE study (NCT04098445) is an ongoing multi-center prospective observational cohort study of lung injury after HSCT in children. We performed oscillometry (Tremoflo© C100, Thorasys, Montreal, CA) at baseline in a cohort of 148 subjects at 4 centers. Children between the ages of 4 and 21 years were eligible for study, of whom 69 had oscillometry pre HSCT. Subjects were identified as either “screen normal (sN)” or “screen abnormal (sAbn)” at time of enrollment by the site PI. “sAbn” subjects had abnormalities in one or more of the following categories: clinical pulmonary function testing (spirometry and DLCO), radiology, clinical history, and bronchoalveolar lavage (BAL). Following ERS 2020 Guidelines for quality control, oscillometry was measured over recording periods of 30 seconds during tidal breathing using commercial equipment (Tremoflo, Thorasys Ltd, 5-37Hz) in at least three trials targeting a coefficient of variation of <15% in respiratory system resistance at5 Hz(R5) for the lowest frequency reported. Variables reported were X5, X11, LogAX, Fres, LogR5-R19. Linear regression analysis was used to compare Transpire subjects to a cohort of 80 normal control patients studied at Children's Hospital of Philadelphia. Differences in oscillometry outcomes between groups were expressed as a height adjusted coefficient which quantitated the mean difference, or ‘offset’ across the height range measured. Results: TRANSPIRE subjects (sN + sAbn) differed significantly from controls (C) in all measured parameters. Similarly, sN vs controls and sAbn vs controls differed significantly on all parameters. However, there were no statistically significant differences in X5, X11, Log Ax, Fres, or Log R5-R19 between sN and sAbn subjects. Conclusions: In a multicenter study of oscillometry in a cohort of children undergoing HSCT, we found that subjects identified as normal by screening at enrollment in fact had abnormal oscillometry compared to controls. Furthermore, there was not good concordance between our screening tool and oscillometry results, with abnormal oscillometry seen in both screen-normal and screen-abnormal subjects. These findings suggest that patients undergoing HSCT have dysfunction of the respiratory system which may not be recognized when evaluating by spirometry, imaging, BAL, and clinical history.
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».