Abstract Details

Title At-Home Telespirometry (AHT) in Amyotrophic Lateral Sclerosis (ALS): Digital Health Technology and Quality Control

Topic Neuromuscular and Clinical Neurophysiology (EMG)

Presentation(s) P10 - Poster Session 10 (8:00 AM-9:00 AM)

Poster/Presentation
Number 10-009

Background N/A

Objective Smart phone mobile application (Breathe Easy app) with data dashboard (https://www.zephyrx.com/) receive and display results of remote Forced Vital Capacity (FVC), accelerated in use during COVID-19 pandemic. We assessed the reliability of FVC as reported with in-clinic conventional (Viaire and Vyasis, USA) and in-clinic and at-home portable (MIR Spirobank Smart, Italy) spirometers that calculated FVC as percentage of predicted values based on Global lung initiative (GLI)-2012 reference standard.

Design/Methods In this retrospective study, 22 out of 99 ALS patients seen in clinic between July 2020 to June 2021 were analyzed . Independent analysis of FVC % predicted values acquired with portable spirometer was performed using GLI-2012 online calculator equations based on age, height, gender and ethnicity. To confirm that the same reference standard GLI-2012 was displayed by the software application, a web-based tool was used to calculate % predicted FVC to confirm that spirometric values were standardized according to GLI-2012 (gli-calculator.ersnet.org).

Results A third of dashboard-reported measurements were found to be 1% less than calculated measurements (29 out of 87 portable spirometry measurements) and appeared to be a fairly consistent difference in the first 1/3 of FVC followed longitudinally. Query was brought to the attention of the ZephyRx software development team. Dashboard algorithm was assessed to investigate for possible systematic error to account for the difference. The automated dashboard reporting of age using exact birth date to one decimal place on the day of testing as opposed to birth year used with manual calculations was confirmed to result in the 1% predicted difference in manually calculated FVC.

Conclusions Reported difference in spirometric values can be due to systematic difference in spirometric reference standards or a true difference in pulmonary function. ALS-specific digital health technology require vetting by independent ALS neuromuscular and pulmonary researchers and quality testing needs to occur within the clinical realm.

Authors/Disclosures
Bhavya Narapureddy, MBBS (Upstate Medical University) PRESENTER	Dr. Narapureddy has nothing to disclose.
Benjamin R. Brooks, MD, FAAN (Clinical Trials Planning LLC)	Dr. Brooks has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Mitsubishi Tanabe Pharma America. Dr. Brooks has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Medicinova. Dr. Brooks has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. Brooks has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for AB Science. Dr. Brooks has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Ionis. Dr. Brooks has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Mitsubishi Tanabe Pharma America. Dr. Brooks has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Muscular Dystrophy Association. The institution of Dr. Brooks has received research support from Mitsubishi TanabePharma America. Dr. Brooks has received personal compensation in the range of $0-$499 for serving as a Member Annual Surveillance Committee CDC National ALS Registry with Center for Disease Control Agency Toxic Substances Disease Registry. Dr. Brooks has a non-compensated relationship as a Member ALS Quality Measures Subcommittee with American Academy of Neurology that is relevant to AAN interests or activities.
Jenny Meyer, MD (Upstate Medical University)	The institution of Dr. Meyer has received research support from Grifols. The institution of Dr. Meyer has received research support from Medicinova.
Dongliang Wang	No disclosure on file
Birendra Sah (Upstate Medical University)	No disclosure on file
Dragos Manta	No disclosure on file
Urvi G. Desai, MD, FAAN (Dept of Neurology, CMC)	Dr. Desai has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion. Dr. Desai has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. Desai has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Takeda. Dr. Desai has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Argenx. Dr. Desai has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Fulcrum. Dr. Desai has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Catalyst. Dr. Desai has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for UCB. Dr. Desai has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Alexion. Dr. Desai has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Argenx.
Eufrosina I. Young, MD (Upstate University Hospital)	The institution of Dr. Young has received research support from Mitsubishi Tanabe Pharma America.