{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,11]],"date-time":"2026-11-11T05:37:16Z","timestamp":1794375436135,"version":"4.9.0"},"reference-count":65,"publisher":"European Respiratory Society (ERS)","issue":"169","license":[{"start":{"date-parts":[[2023,9,6]],"date-time":"2023-09-06T00:00:00Z","timestamp":1693958400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["publications.ersnet.org"],"crossmark-restriction":true},"short-container-title":["Eur Respir Rev"],"accepted":{"date-parts":[[2023,5,31]]},"published-print":{"date-parts":[[2023,9,30]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The number of patients completing unsupervised home spirometry has recently increased due to more widely available portable technology and the COVID-19 pandemic, despite a lack of solid evidence to support it. This systematic methodology review and meta-analysis explores quantitative differences in unsupervised spirometry compared with spirometry completed under professional supervision.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      We searched four databases to find studies that directly compared unsupervised home spirometry with supervised clinic spirometry using a quantitative comparison (\n                      <jats:italic>e.g.<\/jats:italic>\n                      Bland\u2013Altman). There were no restrictions on clinical condition. The primary outcome was measurement differences in common lung function parameters (forced expiratory volume in 1\u2005s (FEV\n                      <jats:sub>1<\/jats:sub>\n                      ), forced vital capacity (FVC)), which were pooled to calculate overall mean differences with associated limits of agreement (LoA) and confidence intervals (CI). We used the I\n                      <jats:sup>2<\/jats:sup>\n                      statistic to assess heterogeneity, the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool to assess risk of bias and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach to assess evidence certainty for the meta-analyses. The review has been registered with PROSPERO (CRD42021272816).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      3607 records were identified and screened, with 155 full texts assessed for eligibility. We included 28 studies that quantitatively compared spirometry measurements, 17 of which reported a Bland\u2013Altman analysis for FEV\n                      <jats:sub>1<\/jats:sub>\n                      and FVC. Overall, unsupervised spirometry produced lower values than supervised spirometry for both FEV\n                      <jats:sub>1<\/jats:sub>\n                      with wide variability (mean difference \u2212107\u2005mL; LoA=\u2005\u2212509, 296; I\n                      <jats:sup>2<\/jats:sup>\n                      =95.8%; p&lt;0.001; very low certainty) and FVC (mean difference \u2212184\u2005mL, LoA=\u2005\u22121028, 660; I\n                      <jats:sup>2<\/jats:sup>\n                      =96%; p&lt;0.001; very low certainty).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Analysis under the conditions of the included studies indicated that unsupervised spirometry is not interchangeable with supervised spirometry for individual patients owing to variability and underestimation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1183\/16000617.0248-2022","type":"journal-article","created":{"date-parts":[[2023,9,6]],"date-time":"2023-09-06T05:30:17Z","timestamp":1693978217000},"page":"220248","update-policy":"https:\/\/doi.org\/10.1183\/ers-crossmark-policy","source":"Crossref","is-referenced-by-count":44,"title":["Unsupervised home spirometry\n                    <i>versus<\/i>\n                    supervised clinic spirometry for respiratory disease: a systematic methodology review and meta-analysis"],"prefix":"10.1183","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1957-5336","authenticated-orcid":false,"given":"Rohan","family":"Anand","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0647-2503","authenticated-orcid":false,"given":"Rebecca","family":"McLeese","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Busby","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5649-9355","authenticated-orcid":false,"given":"Jonathan","family":"Stewart","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mike","family":"Clarke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3782-659X","authenticated-orcid":false,"given":"William D-C.","family":"Man","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judy","family":"Bradley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"81","published-online":{"date-parts":[[2023,9,6]]},"reference":[{"key":"2024102404133877000_32.169.220248.1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201908-1590ST"},{"key":"2024102404133877000_32.169.220248.2","doi-asserted-by":"publisher","DOI":"10.1183\/20734735.0021711"},{"key":"2024102404133877000_32.169.220248.3","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1164\/rccm.202009-3533SO","article-title":"Global Initiative for the Diagnosis, Management, and Prevention of Chronic Obstructive Lung Disease. 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