Handheld Device Could Simplify COPD Monitoring

A handheld portable device achieves similar results to conventional oscillometry when testing resistance parameters in patients with chronic obstructive pulmonary disease (COPD), a new study found.1 The report, which was published in Physiological Reports, found that readings between the 2 techniques were similar for patients with mild (GOLD 1) COPD and for those with very severe (GOLD 4) disease.

The “hallmark feature” of COPD is a sustained reduction of expiratory airflow, which is typically tracked using spirometry, the authors noted.

In the new report, the authors aimed to see how well the REOM device would perform in a cohort of adults with COPD. | Image credit: Elena - stock.adobe.com

“Notably, however, the spirometry testing process requires substantial patient cooperation and coordination, as well as the capacity and willingness to participate in difficult and strenuous ‘forced’ maximal respiratory maneuvers,” they wrote.

Many patients have difficulty with such tests, making it difficult to gain reliable short- and long-term data. The challenge is particularly pronounced for older patients, they noted.

One possible solution to the problem is the rapid expiratory occlusion monitor (REOM), a portable, lightweight device that can be paired to a smartphone or tablet. The machine uses just 2 resistance values (Reo-fast [Reo-f] and Reo-slow [Reo-s]), and has been found to achieve readings that closely correlate with those of spectral oscillometry-obtained parameters in children with asthma.2

In the new report, the authors aimed to see how well the REOM device would perform in a cohort of adults with COPD.1

“Because acute exacerbations of COPD are a leading cause of hospitalization among all adult chronic diseases, innovations in chronic disease management, including remote patient monitoring solutions, represents an important and growing field of clinical research,” they wrote.

They noted that there are key differences between asthma and COPD, and between the lung mechanics of children and adults.

The primary objective of their research was to see how well Reo-fast and Reo-slow readings would correlated with conventional resistance parameters of spectral oscillometry at 5 and 19 Hz in patients with mild and very severe COPD. They also wanted to see how well the tool could distinguish between mild and very severe COPD, and to see how patients would respond to the REOM device.

The investigators recruited 19 participants, and data for 17 of those patients were included in the final analysis. Of the 17 participants in the analysis, 9 had GOLD 1 COPD, and 8 had GOLD 4 disease.

Correlations were very strong between conventional oscillometry and REOM readings. The adjusted Spearman correlation coefficient for the association between resistance at 5 Hz (R5) and Reo-s using REOM was 0.95 (0.81-0.98). For resistance at 19 Hz (R19) and Reo-f, the adjusted Spearman correlation coefficient was 0.93 (0.79-0.99). Agreement between the two pairs of measurements was also very strong, with mean differences of –0.07 and 0.08, respectively.

Reo-s had perfect discrimination between GOLD 1 and 4 disease, while Reo-f and R5 each misclassified 1 patient, and R19 misclassified 4 patients. Patient feedback for the REOM device was strong, with patients reporting mainly positive impressions of the size and ease of use of the device.

Still, the authors noted that this study was performed at a single site and with a small patient population. It also focused on patients at opposite ends of the disease-severity spectrum. Thus, they said, these results should not be seen as indicating that the REOM device can distinguish between moderate and severe disease, though they said such a question ought to be evaluated in a future study.

In the meantime, though, they said the results of this analysis suggest REOM may be an important option for many patients in the future, particularly those of older age and with more advanced COPD.

References

1. Coutu FA, Malaeb D, Iorio OC, et al. Measuring lung mechanics in patients with COPD using the handheld portable rapid expiratory occlusion monitor (REOM): A cross-sectional study. Physiol Rep. 2025;13(7):e70307. doi:10.14814/phy2.70307

2. Lundblad LKA, Blouin N, Grudin O, et al. Comparing lung oscillometry with a novel, portable flow interrupter device to measure lung mechanics. J Appl Physiol (1985). 2021;130(4):933-940. doi:10.1152/japplphysiol.01072.2020