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Validation of a Portable Game Controller to Assess Peak Expiratory Flow Against Conventional Spirometry in Children: Cross-sectional Study

Title:

Validation of a Portable Game Controller to Assess Peak Expiratory Flow Against Conventional Spirometry in Children: Cross-sectional Study

Chelabi, Khadidja ORCID: https://orcid.org/0000-0002-2577-039X, Balli, Fabio ORCID: https://orcid.org/0000-0002-4769-5810, Bransi, Myriam ORCID: https://orcid.org/0000-0002-7108-4905, Gervais, Yannick ORCID: https://orcid.org/0000-0002-5256-1059, Marthe, Clément ORCID: https://orcid.org/0000-0002-7834-2196 and Tse, Sze Man ORCID: https://orcid.org/0000-0002-0295-0064 (2021) Validation of a Portable Game Controller to Assess Peak Expiratory Flow Against Conventional Spirometry in Children: Cross-sectional Study. JMIR Serious Games, 9 (1). ISSN 2291-9279

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Official URL: https://doi.org/10.2196/25052

Abstract

Background: International asthma guidelines recommend the monitoring of peak expiratory flow (PEF) as part of asthma self-management in children and adolescents who poorly perceive airflow obstruction, those with a history of severe exacerbations, or those who have difficulty controlling asthma. Measured with a peak flow meter, PEF represents a person’s maximum speed of expiration and helps individuals to follow their disease evolution and, ultimately, to prevent asthma exacerbations. However, patient adherence to regular peak flow meter use is poor, particularly in pediatric populations. To address this, we developed an interactive tablet-based game with a portable game controller that can transduce a signal from the user’s breath to generate a PEF value.

Objective: The purpose of this study was to evaluate the concordance between PEF values obtained with the game controller and various measures derived from conventional pulmonary function tests (ie, spirometry) and to synthesize the participants’ feedback.

Methods: In this cross-sectional multicenter study, 158 children (aged 8-15 years old) with a diagnosis or suspicion of asthma performed spirometry and played the game in one of two hospital university centers. We evaluated the correlation between PEF measured by both the game controller and spirometry, forced expiratory volume at 1 second (FEV1), and forced expiratory flow at 25%-75% of pulmonary volume (FEF25-75), using Spearman correlation. A Bland-Altman plot was generated for comparison of PEF measured by the game controller against PEF measured by spirometry. A post-game user feedback questionnaire was administered and analyzed.

Results: The participants had a mean age of 10.9 (SD 2.5) years, 44% (71/158) were female, and 88% (139/158) were White. On average, the pulmonary function of the participants was normal, including FEV1, PEF, and FEV1/forced vital capacity (FVC). The PEF measured by the game controller was reproducible in 96.2% (152/158) of participants according to standardized criteria. The PEF measured by the game controller presented a good correlation with PEF measured by spirometry (r=0.83, P<.001), with FEV1 (r=0.74, P<.001), and with FEF25-75 (r=0.65, P<.001). The PEF measured by the game controller presented an expected mean bias of –36.4 L/min as compared to PEF measured by spirometry. The participants’ feedback was strongly positive, with 78.3% (123/157) reporting they would use the game if they had it at home.

Conclusions: The game controller we developed is an interactive tool appreciated by children with asthma, and the PEF values measured by the game controller are reproducible, with a good correlation to values measured by conventional spirometry. Future studies are necessary to evaluate the clinical impact this novel tool might have on asthma management and its potential use in an out-of-hospital setting.

Divisions:Concordia University > Research Units > Centre for Technoculture, Art and Games
Concordia University > Research Units > Milieux Institute for Arts, Culture and Technology
Concordia University > School of Graduate Studies > Individualized Program
Item Type:Article
Refereed:Yes
Authors:Chelabi, Khadidja and Balli, Fabio and Bransi, Myriam and Gervais, Yannick and Marthe, Clément and Tse, Sze Man
Journal or Publication:JMIR Serious Games
Date:29 January 2021
Funders:
  • Canadian Institute of Health Research (SPOR 151755)
  • French Hospitals Federation - Fonds FHF (#2017)
  • Concordia University Council of Student Life (#63)
  • Concordia University Sustainability Action Fund (#PYPF)
  • Sainte-Justine university hospital
  • Quebec university hospital
  • Breathing Games Association (Switzerland)
Digital Object Identifier (DOI):10.2196/25052
Keywords:asthma; pediatrics; serious game; peak expiratory flow; pulmonary function test, adherence, self-management
ID Code:987956
Deposited By: Fabio Balli
Deposited On:11 Feb 2021 20:42
Last Modified:11 Feb 2021 20:42
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