{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T02:58:40Z","timestamp":1782442720489,"version":"3.54.5"},"reference-count":17,"publisher":"SAGE Publications","issue":"9","license":[{"start":{"date-parts":[[2025,5,22]],"date-time":"2025-05-22T00:00:00Z","timestamp":1747872000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Respiratory Care"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Mechanical insufflation-exsufflation (MI-E) is used to augment secretion clearance in neuromuscular patients with weakened cough strength. Cough peak flow (CPF) is a measure of cough function that is used to assess a patient\u2019s ability to clear secretions, with thresholds set that categorize cough as effective, ineffective or severely ineffective. MI-E is prescribed according to these thresholds, and CPF is used to assess titration of MI-E settings. The Clearway2 (Breas Medical, Stratford-upon-Avon, United Kingdom) displays a real-time CPF, measured by an internal pneumotachograph. This study sought to assess the agreement and repeatability of this displayed CPF, against the reference CPF measurement by a calibrated pneumotachograph.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      This study consisted of two phases (1) lung model (Group A) and (2) acutely unwell individuals with neuromuscular conditions (Group B) and clinically stable individuals with neuromuscular conditions (Group C). Simultaneous CPF measurements were recorded from the MI-E device (CPF\n                      <jats:sub>MI-E<\/jats:sub>\n                      ) and a calibrated pneumotachograph (CPF), which was inserted into the MI-E circuit. Bland-Altman analysis was used to assess agreement between methods of measurement, and repeatability was assessed using a repeated measures analysis of variance.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      During phase 1, 805 simulated coughs were evaluated with the Clearway2. The mean bias toward CPF\n                      <jats:sub>MI-E<\/jats:sub>\n                      was 33\u2009L\/min (95% limits of agreement 6\u201360\u2009L\/min). During phase 2, the mean bias increased to 66\u2009L\/min (95% limits of agreement 13\u2013119\u2009L\/min). CPF\n                      <jats:sub>MI-E<\/jats:sub>\n                      and CPF both had good repeatability in all groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>\n                      The Clearway2 MI-E device provided a real-time CPF measurement that was repeatable and systematically higher than CPF. It may therefore be a useful tool to measure change longitudinally, or in response to changes in MI-E settings, in an individual patient. Caution is advised if using the CPF\n                      <jats:sub>MI-E<\/jats:sub>\n                      to assess cough efficacy against clinical thresholds.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/respcare.12514","type":"journal-article","created":{"date-parts":[[2025,5,22]],"date-time":"2025-05-22T05:15:03Z","timestamp":1747890903000},"page":"1103-1109","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Evaluation of the Accuracy of a Mechanical Insufflation-Exsufflation Device\u2019s Cough Peak Flow Measurement"],"prefix":"10.1177","volume":"70","author":[{"given":"Neeraj M.","family":"Shah","sequence":"first","affiliation":[{"name":"Drs. Shah, Suh, Murphy, Ms. Madden-Scott, Apps, Mr. Hart, and Kaltsakas are affiliated with Lane Fox Clinical Respiratory Physiology Centre, Guy\u2019s and St Thomas\u2019 NHS Foundation Trust, London, United Kingdom."},{"name":"Drs. Shah, Murphy, Mr. Hart, and Kaltsakas are affiliated with Centre for Human and Applied Physiological Sciences (CHAPS), King\u2019s College London, London, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie","family":"Madden-Scott","sequence":"additional","affiliation":[{"name":"Drs. Shah, Suh, Murphy, Ms. Madden-Scott, Apps, Mr. Hart, and Kaltsakas are affiliated with Lane Fox Clinical Respiratory Physiology Centre, Guy\u2019s and St Thomas\u2019 NHS Foundation Trust, London, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chloe","family":"Apps","sequence":"additional","affiliation":[{"name":"Drs. Shah, Suh, Murphy, Ms. Madden-Scott, Apps, Mr. Hart, and Kaltsakas are affiliated with Lane Fox Clinical Respiratory Physiology Centre, Guy\u2019s and St Thomas\u2019 NHS Foundation Trust, London, United Kingdom."},{"name":"Ms. Apps and Mr. Hart are affiliated with Department of Critical Care, Guy\u2019s and St Thomas\u2019 NHS Foundation Trust, London, United Kingdom."},{"name":"Ms. Apps is affiliated with GKT School of Medical Education, King\u2019s College London, London, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ema","family":"Swingwood","sequence":"additional","affiliation":[{"name":"Ms. Swingwood is affiliated with Adult Therapy Services, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, United Kingdom."},{"name":"Ms. Swingwood is affiliated with Centre for Health and Clinical Research, School of Health and Social Wellbeing, University of the West of England, Bristol, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harriet","family":"Shannon","sequence":"additional","affiliation":[{"name":"Drs. Shannon and Osman are affiliated with Infection, Immunity and Inflammation Department, UCL Great Ormond Street Institute of Child Health, London, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eui-Sik","family":"Suh","sequence":"additional","affiliation":[{"name":"Drs. Shah, Suh, Murphy, Ms. Madden-Scott, Apps, Mr. Hart, and Kaltsakas are affiliated with Lane Fox Clinical Respiratory Physiology Centre, Guy\u2019s and St Thomas\u2019 NHS Foundation Trust, London, United Kingdom."},{"name":"Dr. Suh is affiliated with Faculty of Life Sciences and Medicine, King\u2019s College London, London, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas","family":"Hart","sequence":"additional","affiliation":[{"name":"Drs. Shah, Suh, Murphy, Ms. Madden-Scott, Apps, Mr. Hart, and Kaltsakas are affiliated with Lane Fox Clinical Respiratory Physiology Centre, Guy\u2019s and St Thomas\u2019 NHS Foundation Trust, London, United Kingdom."},{"name":"Drs. Shah, Murphy, Mr. Hart, and Kaltsakas are affiliated with Centre for Human and Applied Physiological Sciences (CHAPS), King\u2019s College London, London, United Kingdom."},{"name":"Ms. Apps and Mr. Hart are affiliated with Department of Critical Care, Guy\u2019s and St Thomas\u2019 NHS Foundation Trust, London, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgios","family":"Kaltsakas","sequence":"additional","affiliation":[{"name":"Drs. Shah, Suh, Murphy, Ms. Madden-Scott, Apps, Mr. Hart, and Kaltsakas are affiliated with Lane Fox Clinical Respiratory Physiology Centre, Guy\u2019s and St Thomas\u2019 NHS Foundation Trust, London, United Kingdom."},{"name":"Drs. Shah, Murphy, Mr. Hart, and Kaltsakas are affiliated with Centre for Human and Applied Physiological Sciences (CHAPS), King\u2019s College London, London, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leyla","family":"Osman","sequence":"additional","affiliation":[{"name":"Drs. Shannon and Osman are affiliated with Infection, Immunity and Inflammation Department, UCL Great Ormond Street Institute of Child Health, London, United Kingdom."},{"name":"Dr. Osman is affiliated with Department of Physiotherapy, Guy\u2019s and St Thomas\u2019 NHS Foundation Trust, London, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick B.","family":"Murphy","sequence":"additional","affiliation":[{"name":"Drs. Shah, Suh, Murphy, Ms. Madden-Scott, Apps, Mr. Hart, and Kaltsakas are affiliated with Lane Fox Clinical Respiratory Physiology Centre, Guy\u2019s and St Thomas\u2019 NHS Foundation Trust, London, United Kingdom."},{"name":"Drs. Shah, Murphy, Mr. Hart, and Kaltsakas are affiliated with Centre for Human and Applied Physiological Sciences (CHAPS), King\u2019s College London, London, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,5,22]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1159\/000529377"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm\/138.1.5"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1136\/thx.2008.110726"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.01214-2018"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.rmed.2018.01.012"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.06321"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.110.6.1566"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.118.5.1390"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.06124"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2023.10.015"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.02345"},{"issue":"3","key":"e_1_3_3_13_2","first-page":"307","article-title":"Measurement in medicine: the analysis of method comparison studies","volume":"32","author":"Altman DG","year":"1983","unstructured":"Altman DG, , Bland JM. Measurement in medicine: the analysis of method comparison studies. J Royal Statistical Society: Series D (The Statistician), 1983; 32(3):307\u2013317.","journal-title":"J Royal Statistical Society: Series D (The Statistician)"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1088\/0967-3334\/36\/2\/243"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.rppnen.2016.08.003"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.10086"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200612-1841OC"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2019.06.012"}],"container-title":["Respiratory Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1089\/respcare.12514","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/respcare.12514","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/respcare.12514","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T01:36:54Z","timestamp":1777685814000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1089\/respcare.12514"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,22]]},"references-count":17,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2025,9]]}},"alternative-id":["10.1089\/respcare.12514"],"URL":"https:\/\/doi.org\/10.1089\/respcare.12514","relation":{},"ISSN":["1943-3654","1943-3654"],"issn-type":[{"value":"1943-3654","type":"print"},{"value":"1943-3654","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,22]]}}}