Development of threshold values ​​for the severity of asthma in children using the oscillometry technique.

Summary


This project aims to establish the threshold values ​​for the severity of asthma in children and is based on a first clinical study already underway aimed at establishing the pediatric reference values ​​of the oscillometric measurements. These reference values ​​form the basis for determining the pulmonary resistance threshold values ​​to classify the severity of bronchial obstruction as mild, moderate, or severe. The project involves the evaluation, in children presenting to the emergency room or hospitalized for an asthma attack, of the pulmonary resistance by oscillometry with the Tremoflo device as well as other clinical and standard pulmonary function measurements, before and after treatment with bronchodilator. The objectives are to define the best parameters to identify the severity and response to treatment and to identify the threshold values ​​of these parameters, measured on the Tremoflo, making it possible to determine with accuracy and precision (1) if the obstruction of the bronchi is mild, moderate, or severe, and (2) how much the obstruction has improved. These thresholds are essential for evaluating the clinical utility of the Tremoflo device specifically and of this technology (oscillometry) in general for the measurement of pulmonary function in children. As the treatment of asthma is based on the severity of the obstruction of the bronchi, the confirmation of the established severity thresholds with evidence is critical to their use to guide the treatment and therefore for the subsequent evaluation of the usefulness. clinic of this technology.

This acquisition of threshold values ​​is part of a larger project in 5 phases: the reference values ​​(Phase 1) and threshold values ​​(Phase 2) are critical elements which will be integrated into a clear report for the doctor and assessed (Phase 3); this report and these critical elements will then be used in a pilot clinical study (phase 4) to demonstrate the feasibility of a pan-Canadian Canada-wide multicentre randomized clinical trial (phase 5). The overall objective is to demonstrate the clinical utility of adding oscillometry to clinical assessment in pediatric patients; indeed, early detection of bronchial blockage and a more personalized therapeutic adjustment in children would improve the quality of care, children’s health and costs to the health system.

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