![]() 8 The application collects and uploads the data automatically to a secure cloud server managed by digiDoc Technologies (Egersund, Norway). Sound capture is performed by the smartphone microphone, and several software algorithms are applied to first estimate the frequency and harmonic following, then linear multivariate ridge regression is applied to find the flow rate, and eventually PEF. The frequency can then be mapped to the inlet airflow rate, allowing for PEF measurement. The pitch varies directly with the inlet air flow rate. As air enters the outlet, the whistle produces a sound. Air is blown into the inlet, flows to the main chamber, where the air is compressed as it whirls around in a vortex and eventually exits through the vertical outlet on the top of the main chamber. The hardware device is a “vortex whistle,” which emits a frequency that is directly determined by the air flow rate passing through the whistle. The software is an application named Blowfish running on a commercial smartphone ( Apple's iPhone). ![]() The hardware is a plastic whistle consisting of an inlet, a circular main chamber, and a vertical outlet ( Fig. The device consists of a combination of hardware and software. 8 The aim of this observational study was to assess the feasibility for children with asthma to use the vortex whistle and smart phone application to measure PEF twice daily during a 4-week period. 7Ī novel three-dimensional printed vortex whistle using a smartphone's built-in microphone as a spirometer has been designed and evaluated as a useful portable alternative to clinical spirometry for managing moderate airway obstruction. 5 Mobile phones and web based applications offer new possibilities for guided self-management, 6 and a Cochrane review from 2011 concluded that telehealthcare has the potential to reduce the risk for hospital admissions for asthma. ![]() ![]() Smart phone applications with features such as diaries, reminders for medications, places to document triggers, and PEF monitoring are associated with increased knowledge and ability to self-judge the patient's asthma severity. 2 Compliance and accuracy are challenging in home spirometry, 3 but may be improved using electronic peak flow meters. 2 In addition, both multiple and daily PEF recordings are needed to obtain reliable estimates of air flow variability, and monitoring airflow variability by PEF therefore requires good compliance. 1 Compared to adults, there is less evidence to support the routine use of PEF recording in the diagnosis and monitoring of asthma in children. 1 However, these features may not always be present or easy to assess in children with asthma, and airflow variability may also be confirmed by diurnal variability of peak expiratory flow (PEF) >13%. 1, 2 Airflow variability may be confirmed by >12% increase in forced expiratory flow in 1 second (FEV 1) after inhaling a bronchodilator or after 4 weeks of anti-inflammatory treatment. The high rate of successful recordings and parental satisfaction suggests that the clinical utility of the solution should be further studied.Īsthma is characterized by airway inflammation, a history of airway symptoms such as wheeze, cough, and shortness of breath, and variable airflow obstruction. The median parental score (potential score 0–20) of the application was 18 (15–20).ĭiscussion/Conclusion: The study shows promising results for home monitoring of PEF by an electronic device with automatic teletransmission. For the remaining 21 children, the median (quartiles) days with at least one measurement during the period were 27 (21–29.5), and on median 18 (9–24) days PEF was recorded twice daily. Results: One child did not manage to upload PEF. At the end, the parents graded the device and application. At inclusion, the Pediatric Asthma Quality of Life Questionnaire and the Childhood Asthma Control Test were answered. Through mathematical algorithms, the sound was transferred to PEF, which was uploaded to a server. ![]() Materials and Methods: Twice daily during 4 weeks, children aged 5–12 years with current asthma rated their asthma condition electronically on the smart phone application Blowfish before inhaling deeply then exhaling into the device to produce a high-pitched sound recorded by the application. In this feasibility study, we aimed to study if asthmatic children can measure PEF at home twice daily during a 4-week period using a device designed as a “whistle” and a smart phone software application. Home monitoring of PEF may be helpful to diagnose and monitor asthma. Introduction: Variable airflow obstruction that can be confirmed by diurnal variability of peak expiratory flow (PEF) >13% is an important characteristic of asthma. ![]()
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