Validity of the Espiro Mobile Application in the Interpretation of Spirometric Patterns: An App Accuracy Study

Diagnostics (Basel). 2023 Dec 22;14(1):29. doi: 10.3390/diagnostics14010029.

Abstract

Spirometry is a pulmonary function test where correct interpretation of the results is crucial for accurate diagnosis of disease. There are online tools to assist in the interpretation of spirometry results; however, as yet none are validated. We evaluated the interpretation accuracy of the Espiro app using pulmonologist interpretations as the gold standard. This is an observational descriptive study in which 118 spirometry results were interpreted by the Espiro app, two pulmonologists, two primary care physicians, and two residents of a primary care training program. We determined the interpretation accuracy of the Espiro app and the concordance of the pattern and severity interpretation between the Espiro app and each of the observers using Cohen's kappa coefficient (k). We obtained a sensitivity and specificity for the Espiro app of 97.5% (95% confidence interval (CI): 86.8-99.9%) and 94.9% (95%CI: 87.4-98.6%) with pulmonologist 1 and 100% (95%CI: 91.6-100%) and 98.7% (95%CI: 92.9-99.9%) with pulmonologist 2. The concordance for the pattern interpretation was greater than k 0.907, representing almost perfect agreement. The concordance of the severity interpretation was greater than k 0.807, representing substantial to almost perfect agreement. We concluded that the Espiro app is a valid tool for spirometry interpretation.

Keywords: clinician tools; primary care; respiratory illness; spirometry interpretation.

Grants and funding

This research was funded by the Institut Universitari d’Investigació en Atenció Primària-IDIAP Jordi Gol predoctoral fellowship, grant number PREDOC-ECO-21/15. The APC was funded by the Departament de Recerca i Universitats de la Generalitat de Catalunya to the ISAC Research Group (Intervencions Sanitàries i Activitats Comunitàries; 2021 SGR 00884).