Abstract
Background: Multiple breath washout (MBW) is increasingly used in the
clinical assessment of patients with cystic fibrosis (CF). Guidelines
for MBW quality control (QC) were developed primarily for retrospective
assessment and central overreading. We assessed whether real-time QC of
MBW data during the measurement improves test acceptability in the
clinical setting. Methods: We implemented standardized real-time QC and
reporting of MBW data at the time of the measurement in the clinical
pediatric lung function laboratory in Bern, Switzerland in children with
CF aged 4-18 years. We assessed MBW test acceptability before (31 tests;
89 trials) and after (32 tests; 97 trials) implementation of real-time
QC and compared agreement between reviewers. Further, we assessed the
implementation of real-time QC at a secondary center in Zurich,
Switzerland. Results: Before implementation of real-time QC in Bern,
only 68% of clinical MBW tests were deemed acceptable following
retrospective QC by an experienced reviewer. After implementation of
real-time QC, MBW test acceptability improved to 84% in Bern. In
Zurich, after implementation of real-time QC, test acceptability
improved from 50% to 90%. Further, the agreement between MBW operators
and an experienced reviewer for test acceptability was 97% in Bern and
100% in Zurich. Conclusion: Real-time QC of MBW data at the time of
measurement is feasible in the clinical setting and results in improved
test acceptability.