Intrabreath Oscillometry (IBO) vs. Spectral Oscillometry (SO) in Detecting Respiratory Disease in Patients Undergoing Hematopoietic Stem Cell Transplantation (HSCT)
Bibliographic record
Abstract
Abstract Rationale: SO is a tidal breathing test which can detect respiratory impairment following HSCT. IBO can measure differences in respiratory system stiffness that occur between end expiration and end inspiration and may be more sensitive than SO in detecting obstructive or restrictive disease in the transplant population. We have previously reported that baseline SO findings are abnormal in patients preparing to undergo HSCT. However, little is known about IBO findings in this population. Methods: The TRANSPIRE study (NCT04098445) is a 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, ages 4-21, at 4 participating centers. Of subjects enrolled so far, 68 had oscillometry pre-HSCT. Following ERS 2020 Guidelines, oscillometry was measured during 3-7 30-second trials using commercial equipment (Tremoflo, Thorasys Ltd, 5-37Hz) targeting a coefficient of variation of <15% in respiratory system resistance at 5HZ (R5). SO variables included X5, X11, AX and Fres. IBO variables included reactance at end expiration (Xee), reactance at end inspiration (Xei) at 5Hz, and their difference both corrected and uncorrected for tidal volume. Linear regression analysis was used to compare Transpire subjects to a cohort of 80 normal control patients studied at Children's Hospital of Philadelphia. Results: There were significant differences between subjects and controls in X5, X11, AX and Fres measured by SO. However no significant differences in IBO were seen between TRANSPIRE and control subjects in (X5ee-X5ei) or (X5ee-X5ei)/VT (Table). Conclusions: We found no differences in IBO parameters in control vs TRANSPIRE subjects. Prior studies have reported that IBO Xee is greater (more negative) than Xei in obstructive disease, whereas Xee-Xei is positive in restrictive disease such as pulmonary fibrosis. Thus, discerning group differences between HSCT and control subjects may be more difficult. Our initial results suggest that baseline intrabreath oscillometry testing does not add discriminatory value beyond spectral oscillometry in distinguishing between normal and HSCT subjects as a group. Future studies should assess whether IBO has promise in detecting obstructive or restrictive disease in individual patients over time following HSCT.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".