UMMS Affiliation
Department of Neurology
Publication Date
2021-08-04
Document Type
Article
Disciplines
Diagnosis | Infectious Disease | Nervous System Diseases | Neurology | Virus Diseases
Abstract
Objective: To measure the correlation between single breath counting (SBC) and forced vital capacity (liters, FVCL) in amyotrophic lateral sclerosis (ALS) patients and to define the utility of SBC for determining when patients meet the threshold for initiation of noninvasive positive pressure ventilation (FVC < 50% predicted [FVCpred]).
Methods: Both patient paced (SBCpp) or externally paced (SBCep) counting along with FVCL+pred and standard clinical data were collected. Linear regression was used to examine SBCpp and SBCep as a predictor of FVCL. Receiver operating characteristic curve analysis evaluated the sensitivity and specificity of SBC categorically predicting FVCpred of < /=50%.
Results: In 30 ALS patients, SBC explained a moderate proportion of the variance in FVCL (SBCpp: R(2)= 0.431, p < 0.001; SBCep: R(2) = 0.511, p < 0.01); this proportion improved when including covariates (SBCpp: R(2)= 0.635, p < 0.01; SBCep: R(2)= 0.657, p < 0.01). Patients with minimal speech involvement performed similarly in unadjusted (SBCpp: R(2) = 0.511, p < 0.01; SBCep: R(2)= 0.595, p < 0.01) and adjusted (SBCpp: R(2) = 0.634, p < 0.01; SBCep: R(2)= 0.650, p < 0.01) models. SBCpp had 100% sensitivity and 60% specificity (area under curve (AUC) = 0.696) for predicting FVCpred < 50%. SBCep had 100% sensitivity and 56% specificity (AUC = 0.696). With minimal speech involvement SBCpp and SBCep both had 100% sensitivity and 76.1% specificity (SPCpp: AUC = 0.845; SBCep: AUC = 0.857).
Conclusions: SBC explains a moderate proportion of variance in FVC and is an extremely sensitive marker of poor FVC. When FVC cannot be obtained, such as during the current COVID-19 pandemic, SBC is helpful in directing patient care.
Keywords
Single breath count, amyotrophic lateral sclerosis, biomarker, neuromuscular disease, ventilation
Rights and Permissions
© 2021 The Author(s). This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited, and is not altered, transformed, or built upon in any way.
DOI of Published Version
10.1080/21678421.2021.1915337
Source
Quinn C, Mcmillan CT, Owegi MA, Almasy K, Douthwright C, Mckenna-Yasek D, Goyal NA, Berry J, Brown RH. Single breath counting is an effective screening tool for forced vital capacity in ALS. Amyotroph Lateral Scler Frontotemporal Degener. 2021;22(sup1):5-8. doi: 10.1080/21678421.2021.1915337. PMID: 34348533. Link to article on publisher's site
Journal/Book/Conference Title
Amyotrophic lateral sclerosis and frontotemporal degeneration
Related Resources
PubMed ID
34348533
Repository Citation
Quinn C, Mcmillan CT, Owegi MA, Almasy K, Douthwright C, Mckenna-Yasek D, Goyal NA, Berry J, Brown RH. (2021). Single breath counting is an effective screening tool for forced vital capacity in ALS. COVID-19 Publications by UMMS Authors. https://doi.org/10.1080/21678421.2021.1915337. Retrieved from https://escholarship.umassmed.edu/covid19/287
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.
Included in
Diagnosis Commons, Infectious Disease Commons, Nervous System Diseases Commons, Neurology Commons, Virus Diseases Commons