Repeatability of the moments of the truncated forced expiratory spirogram

Abstract

It is proposed that if the spirogram is truncated for moment analysis, this should be done with respect to volume and not time. Errors are incurred when the moments of one spirogram are compared with those of another. These errors are maximal with no truncation and are reduced by truncation. A method is described for deriving sequential truncated moments of the forced expiratory spirogram. The repeatability and discriminatory power of the truncated moments were assessed over five consecutive days in 21 symptom-free subjects and were compared with conventional spirometric tests. The first and second moments about the origin of the spirogram (α1 and α2), the moment ratio (√α2/α1) and the forced expiratory time to truncation (FET) are progressively less repeatable within individuals the later the truncation point. The discriminatory power of α1 and α2 and FET declines with later truncation but the discriminatory power of the moment ratio is maximal with truncation at 85% forced vital capacity (FVC) and diminishes sharply if truncation is beyond 95% FVC. At 75% FVC truncation α1 is as good as FEV1% in discriminating between our subjects, whereas α1 at 100% FVC is only half as good as FEV1%. The moment ratio at 90% FVC truncation is highly reproducible (mean within person coefficient of variation 2.1%), has important discriminatory power and is little influenced by events early in the spirogram (correlation with FEV1% r = -0.61, p < 0.001). The moment ratio at 90% of FVC has attributes which may be useful in detecting early airway obstruction and its further study is warranted in order to establish its normal range and predictive value.