Interpreting respiratory oscillometry in adults with asthma or COPD: findings of an international Delphi study
Bibliographic record
Abstract
Background Respiratory oscillometry measures the physiological effort and mechanics of moving air in and out of the lungs during normal breathing. It provides complementary information to spirometry. Uncertainty regarding the interpretation of oscillometry is a barrier to routine use. The aim of this study was to aid in oscillometry interpretation among adults with asthma or COPD by generating expert consensus statements. Methods A Delphi method was used to develop consensus statements regarding the clinical use of oscillometry in adults to identify abnormal lung function, bronchodilator response and minimal clinically important differences. Initial statements were refined in the brainstorming round. Statements were assessed by 60 pulmonologists over three rounds, with consensus defined as ≥70% agreement. Results Pulmonologists agreed that oscillometry is clinically useful to assess abnormal lung function and its severity, and to measure bronchodilator response. High consensus was reached for resistance at 5 Hz ( R 5 , 85%), reactance at 5 Hz ( X 5 , 79%) and area under the reactance curve ( A X , 77%) based on z-scores, where >1.64 was considered abnormal for R 5 and A X and < −1.64 was considered abnormal for X 5 . For measuring bronchodilator response, good agreement was based on using percentage change for R 5 , X 5 and A X . Discussion This international Delphi study combined evidence-based and expert opinion to inform clinicians in the interpretation of respiratory oscillometry. Focusing on a few key parameters of oscillometry will allow clinicians to become confident in its everyday use to assess abnormal lung function, grade severity of impairment, monitor progression over time and assess bronchodilator response.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.022 | 0.007 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.002 | 0.004 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.004 | 0.002 |
| Research integrity | 0.000 | 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 teacher head, 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".