Exercise Oscillatory Ventilation: Interreviewer Agreement and a Novel Determination

Authors

Clinton Brawner, Henry Ford HealthFollow
Jonathan K. Ehrman, Henry Ford HealthFollow
Jonathan Myers
Paul Chase
Baruch Vainshelboim
Shadi Farha
Matthew A. SavalFollow
Rita McGuire
Bunny Pozehl
Steven J. Keteyian, Henry Ford HealthFollow

Recommended Citation

Brawner CA, Ehrman JK, Myers J, Chase P, Vainshelboim B, Farha S, Saval MA, McGuire R, Pozehl B, Keteyian SJ. Exercise oscillatory ventilation: Inter-reviewer agreement and a novel determination. Med Sci Sports Exerc. 2018 ;50(2):369-374.

Document Type

Article

Publication Date

2-1-2018

Publication Title

Medicine and science in sports and exercise

Abstract

INTRODUCTION: Determination of exercise oscillatory ventilation (EOV) is subjective, and the interreviewer agreement has not been reported. The purposes of this study were, among patients with heart failure (HF), as follows: 1) to determine the interreviewer agreement for EOV and 2) to describe a novel, objective, and quantifiable measure of EOV.

METHODS: This was a secondary analysis of the HEART Camp: Promoting Adherence to Exercise in Patients with Heart Failure study. EOV was determined through a blinded review by six individuals on the basis of their interpretation of the EOV literature. Interreviewer agreement was assessed using Fleiss kappa (κ). Final determination of EOV was based on agreement by four of the six reviewers. A new measure (ventilation dispersion index; VDI) was calculated for each test, and its ability to predict EOV was assessed with the receiver operator characteristics curve.

RESULTS: Among 243 patients with HF (age, 60 ± 12 yr; 45% women), the interreviewer agreement for EOV was fair (κ = 0.303) with 10-s discrete data averages and significantly better, but only moderate (κ = 0.429) with 30-s rolling data averages. Prevalence rates of positive and indeterminate EOVs were 18% and 30% with the 10-s discrete averages and 14% and 13% with the 30-s rolling averages, respectively. VDI was strongly associated with EOV, with areas under the receiver operator characteristics curve of 0.852 to 0.890.

CONCLUSIONS: Interreviewer agreement for EOV in patients with HF is fair to moderate, which can negatively affect risk stratification. VDI has strong predictive validity with EOV; as such, it might be a useful measure of prognosis in patients with HF.

Medical Subject Headings

Aged; Exercise; Exercise Test; Female; Heart Failure; Humans; Male; Middle Aged; Pulmonary Ventilation; Respiration

PubMed ID

28902683

Volume

50

Issue

2

First Page

369

Last Page

374