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|Title||Reliability of a Noninvasive Measure of V./Q. Mismatch for Bronchopulmonary Dysplasia.|
|Publication Type||Journal Article|
|Year of Publication||2015|
|Authors||Bamat NA, Ghavam S, Liu Y, DeMauro SB, Jensen EA, Roberts R, Yoder BA, Kirpalani H|
|Journal||Ann Am Thorac Soc|
|Date Published||2015 May|
|Keywords||Bronchopulmonary Dysplasia, Female, Humans, Infant, Infant, Newborn, Infant, Premature, Infant, Premature, Diseases, Male, Oxygen Consumption, Prospective Studies, Reproducibility of Results, Respiratory Function Tests, ROC Curve, Severity of Illness Index|
RATIONALE: Currently used definitions of bronchopulmonary dysplasia (BPD) lack a continuous measure of disease severity.
OBJECTIVES: To determine if an indirect measure of V./Q. mismatch is reliable when simplified to facilitate more widespread use for grading disease severity in BPD at 36 weeks postmenstrual age.
METHODS: We used prospectively collected data from 32 preterm infants undergoing an oxygen reduction test at 36 weeks postmenstrual age to perform a simplified indirect assessment of V./Q. mismatch for each infant. Independent raters applied the model, and interrater reliability for a quantitative measure of mismatch was measured by intraclass correlation coefficient. A receiver operating characteristic curve evaluated the impact of increasing degrees of V./Q. mismatch on diagnosing BPD as defined by oxygen reduction test failure.
MEASUREMENTS AND MAIN RESULTS: Concordance for the quantitative measure of V./Q. mismatch between independent raters improved from 0.72 (confidence interval [CI], 0.48-0.86) to 0.93 (CI, 0.87-0.96) after refinement of instructions for applying the simplified model. Higher degrees of mismatch were increasingly predictive of oxygen reduction test failure, with a receiver operating characteristic curve analysis area under the curve of 0.83 (CI, 0.68-0.99; P = 0.03).
CONCLUSIONS: A simplified indirect measure of V./Q. mismatch for diagnosing and grading disease severity in BPD has high reliability and can be performed with data obtained during a standard oxygen reduction test. This should facilitate more widespread investigation of this model as a technique for characterizing BPD severity.
|Alternate Journal||Ann Am Thorac Soc|
|PubMed Central ID||PMC4418335|
|Grant List||U10 HD053124 / HD / NICHD NIH HHS / United States |
U-0 HD053124-01 / HD / NICHD NIH HHS / United States