Between-Session Reliability and Agreement of Body-Plethysmographic Lung Volumes in a Legacy Pulmonary Function Cohort
5 affiliations
- 1Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy
- 2Department of Respiratory Diseases, San Giuseppe Moscati Hospital, 83100 Avellino, Italy
- 3Department of Medicine and Health Sciences ‘Vincenzo Tiberio’, University of Molise, 86100 Campobasso, Italy
- 4Casa di Cura “Clinica Montevergine”, 83013 Mercogliano, Italy
- 5Department of Translational Medical Sciences, Federico II University of Naples, Via S. Pansini 5, 80131 Naples, Italy
Abstract
Background: Serial interpretation of lung volumes requires assessing both reliability and agreement. We examined these properties in a historical clinical dataset. Methods: This retrospective secondary analysis included 72 participants, excluding seven same-session pre/post-bronchodilator pairs. The primary analysis used 19 separately dated pairs labelled pre-bronchodilator at both examinations; the expanded 65-pair analysis was exploratory. Documented intervals were two to three days; the investigator retrospectively confirmed separate-day examinations within six days for all 65 pairs. Total lung capacity (TLC) and residual volume (RV) were principal outcomes; functional residual capacity was secondary and available in the same 19 participants. Analyses included two-way mixed-effects, absolute-agreement, single-measure intraclass correlation coefficients (ICCs), Lin’s concordance correlation coefficient, Gaussian reference limits, empirical difference quantiles, and leave-one-out analyses. Results: Fourteen primary participants had recorded chronic obstructive pulmonary disease labels without independently verified diagnostic post-bronchodilator spirometry. Primary TLC and RV ICCs were 0.947 (95% bootstrap confidence interval 0.838–0.988) and 0.940 (0.818–0.974), respectively. Mean second-minus-first differences were −0.033 and −0.015 L, with Gaussian reference limits of −0.964 to 0.898 L and −0.934 to 0.904 L, respectively. Corresponding empirical 2.5th–97.5th percentiles were −1.122 to 0.641 L and −0.875 to 0.803 L. Removing one observation reduced the standard deviation of paired differences by up to 28.8% for TLC and 14.8% for RV. Conclusions: High reliability estimates coexisted with appreciable paired variation. Unverified technical quality and clinical stability preclude attributing this variation solely to measurement error or establishing clinical response thresholds.
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BibTeX
@article{izzo2026betweensession,
title = {{Between-Session Reliability and Agreement of Body-Plethysmographic Lung Volumes in a Legacy Pulmonary Function Cohort}},
author = {Carmine Izzo and Alessandro Izzo and Pasquale Mone and Simona Musto and Michele Ciccarelli and Francesco Giallauria},
journal = {Journal of clinical medicine},
year = {2026},
month = oct,
doi = {10.3390/jcm15197704},
url = {https://europepmc.org/article/PMC/PMC13666337},
note = {CC BY},
}
RIS
TY - JOUR
TI - Between-Session Reliability and Agreement of Body-Plethysmographic Lung Volumes in a Legacy Pulmonary Function Cohort
AU - Carmine Izzo
AU - Alessandro Izzo
AU - Pasquale Mone
AU - Simona Musto
AU - Michele Ciccarelli
AU - Francesco Giallauria
PY - 2026
DA - 2026/10/01
JO - Journal of clinical medicine
DO - 10.3390/jcm15197704
UR - https://europepmc.org/article/PMC/PMC13666337
AB - Background: Serial interpretation of lung volumes requires assessing both reliability and agreement. We examined these properties in a historical clinical dataset. Methods: This retrospective secondary analysis included 72 participants, excluding seven same-session pre/post-bronchodilator pairs. The primary analysis used 19 separately dated pairs labelled pre-bronchodilator at both examinations; the expanded 65-pair analysis was exploratory. Documented intervals were two to three days; the investigator retrospectively confirmed separate-day examinations within six days for all 65 pairs. Total lung capacity (TLC) and residual volume (RV) were principal outcomes; functional residual capacity was secondary and available in the same 19 participants. Analyses included two-way mixed-effects, absolute-agreement, single-measure intraclass correlation coefficients (ICCs), Lin’s concordance correlation coefficient, Gaussian reference limits, empirical difference quantiles, and leave-one-out analyses. Results: Fourteen primary participants had recorded chronic obstructive pulmonary disease labels without independently verified diagnostic post-bronchodilator spirometry. Primary TLC and RV ICCs were 0.947 (95% bootstrap confidence interval 0.838–0.988) and 0.940 (0.818–0.974), respectively. Mean second-minus-first differences were −0.033 and −0.015 L, with Gaussian reference limits of −0.964 to 0.898 L and −0.934 to 0.904 L, respectively. Corresponding empirical 2.5th–97.5th percentiles were −1.122 to 0.641 L and −0.875 to 0.803 L. Removing one observation reduced the standard deviation of paired differences by up to 28.8% for TLC and 14.8% for RV. Conclusions: High reliability estimates coexisted with appreciable paired variation. Unverified technical quality and clinical stability preclude attributing this variation solely to measurement error or establishing clinical response thresholds.
SN - 2077-0383
ER -