Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Pilot Feasibility of Web-Based Implementation of Respiratory Therapist Supervised At-Home Telespirometry in Amyotrophic Lateral Sclerosis

Eufrosina Ison Young
* ORCID logo ,
Dongliang Wang
,
Jeffrey Collins
,
Jenny Meyer
,
Bhavya Narapureddy
,
Elizabeth Rescorl
,
Scott Hildebrandt
,
Christine Cottet
,
Yoland Fradette
,
Joseph McDonald
,
Birendra Sah
,
Dragos Manta
,
Lena Deb
,
Emma Blystone
,
Urvi Desai
,
Benjamin Rix Brooks
ORCID logo
Version 1 : Received: 3 July 2023 / Approved: 3 July 2023 / Online: 3 July 2023 (10:23:14 CEST)

How to cite: Young, E.I.; Wang, D.; Collins, J.; Meyer, J.; Narapureddy, B.; Rescorl, E.; Hildebrandt, S.; Cottet, C.; Fradette, Y.; McDonald, J.; Sah, B.; Manta, D.; Deb, L.; Blystone, E.; Desai, U.; Brooks, B.R. Pilot Feasibility of Web-Based Implementation of Respiratory Therapist Supervised At-Home Telespirometry in Amyotrophic Lateral Sclerosis. Preprints 2023, 2023070051. https://doi.org/10.20944/preprints202307.0051.v1 Young, E.I.; Wang, D.; Collins, J.; Meyer, J.; Narapureddy, B.; Rescorl, E.; Hildebrandt, S.; Cottet, C.; Fradette, Y.; McDonald, J.; Sah, B.; Manta, D.; Deb, L.; Blystone, E.; Desai, U.; Brooks, B.R. Pilot Feasibility of Web-Based Implementation of Respiratory Therapist Supervised At-Home Telespirometry in Amyotrophic Lateral Sclerosis. Preprints 2023, 2023070051. https://doi.org/10.20944/preprints202307.0051.v1

Abstract

Respiratory therapist(RT)internet-supervised At-Home Telespirometry(AHT)was validated in pilot 22/95=23% ALS Clinic population. Erect, supine Vital Capacity(eFVC, sFVC)were measured longitudinally using ZephyRx smartphone interface and database recording in-clinic-conventional(Viaire-Vyasis-)and at-home-portable(MIR-Spirobank-Smart-)spirometers. Bland-Altman(BA)analysis supported content validity-precision and 7-day-test-re-test-validity [mean difference=0.15L(conventional–portable;95%CI -0.40L, 0.70L); = 2.7% predicted (conventional-portable;95%CI -12.1%, 17.5%) ]meeting ATS-ERS performance standards. RT Internet-supervised AHT measured sFVC was more frequently obtained[35/52=67.3 %]in-home-vs-in-clinic sFVC[9/21=42.9 %](Chi-Square;P=0.0533). Monthly mean eFVC slope decline for the eFVC > 60 % predicted baseline cohort was – 1.24% predicted per month[95% CI -2.15 ,-0.33% predicted]statistically significantly(P=0.015)less compared with the – 5.86% predicted per month[95% CI -9.44, -2.29 % predicted]decline for the eFVC < 60 % predicted baseline cohort and in this cohort was associated with statistically significant decreased survival(P=0.0219). RT Internet-supervised AHT facilitated initiation of non-invasive ventilation(NIV)in 5/22[23%]patients including 3/4[75%] homebound subjects. RT Internet-supervised AHT can be deployed for ALS patients stratified according to baseline eFVC for earlier detection of eFVC and sFVC decreases between clinic visits. A prospective research study[NCT05106569]is ongoing to further define the capability of online deployment of Respiratory therapist(RT)internet-supervised AHT in the timely initiation of NIV use to improve ALS respiratory care in larger numbers of ALS subjects.

Keywords

Forced Vital Capacity; At-Home Telespirometry; Non-Invasive Ventilation; Amyotrophic Lateral Sclerosis

Subject

Medicine and Pharmacology, Neuroscience and Neurology

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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