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Abstract Details

Smartphone Software Application-mediated At-home Telespirometry (AHT) Artificial Intelligence(AI)-algorithm Identifies Similar Proportion of Valid Erect (eFVC) and Supine (sFVC) Forced Vital Capacity Measurements
Neuromuscular and Clinical Neurophysiology (EMG)
P5 - Poster Session 5 (5:30 PM-6:30 PM)
11-013

Validate adherence to American Thoracic Society(ATS) 2019 Spirometry Guidelines when measuring eFVC/sFVC in ALS subjects with AHT monitored by AI-algorithm assessing FVC flow-volume-curves(Graham 2019).

Smartphone software-mediated AHT is being deployed world-wide to permit timely management with earlier treatment of ALS respiratory associated co-morbidities(Young Muscle&Nerve 2022, 2023; Moran Muscle&Nerve 2023). Each eFVC/sFVC measurement, previously evaluated by respiratory therapist(RT)can now be assessed by AI-algorithm that classifies eFVC/sFVC by flow-volume-curve characteristics and number of acceptable repeatable measurements within 0.150L(3-A, 2-B)|0.200L(2-C)|0.250 L(2-D)|> 0.250 L(2-E) or (1- acceptable-E)|none acceptable by prior repeatability criteria but usable based on at least one acceptable flow volume-curve(1-U). 

120 data sets representing the best eFVC/sFVC measurement in 22 ALS subjects participating in a pandemic pilot feasibility deployment of the ZephyRx-Breath-Easy-software application with MIR-turbine-spirometer and ZephyRx-cloud-database-dashboard to permit longitudinal AHT over median 194 days[95%CI=92, 223 days]. 

eFVC/sFVC ATS 2019 standards[classifications A,B,C,D,E]were met for mean-82.6%[95%CI=69.9%,95.2%]of measurements in ALS subjects increasing to mean-87.7%[95%CI=73.9 %,101.5 %]for classifications A,B,C,D,E,U]. eFVC/sFVC ATS 2019 standards[classifications A,B,C,D,E,U]were met for mean-93.2%[95%CI=78.5%,107.8%]of measurements for ALS subjects with eFVC-BL>60 %p, not statistically different from mean-82.5%[95%CI=-9.8%,174.4%]of measurements for ALS subjects with eFVC-BL<60 %p. eFVC/sFVC ATS 2019 failure(F)classification stratified by eFVC-BL>or<60 %p is not significantly increased in the eFVC-BL<60%p cohort in this observational study. ALS subject Test-ReTest repeatability was similar for eFVC/sFVC measurements despite stratification by eFVC-BL>or<60 %p.

This is the first report evaluating an ATS 2019 standards-based AI-algorithm in an ALS subject population monitored by AHT. eFVC/sFVC demonstrated high comparable attainment of benchmark indicators of appropriate eFVC/sFVC measurement when stratified by eFVC-BL>or<60 %p. We recommend that each iterative change AI-algorithm release be evaluated in the appropriate patient population to determine whether the benchmark indicators are maintained overtime. Future studies will include comparative assessment of best versus not-best assessments in his ALS clinic population.
Authors/Disclosures
George P. Slavinski, Respiratory Therapist (SUNY Upstate Medical University)
PRESENTER 		Mr. Slavinski has nothing to disclose.
Eufrosina I. Young, MD (Upstate University Hospital) The institution of Dr. Young has received research support from Mitsubishi Tanabe Pharma America.
Dongliang Wang Dongliang Wang 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. 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 好色先生 that is relevant to AAN interests or activities.