| 1. |
- Sandberg, Jacob, et al.
(författare)
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Relating Experienced To Recalled breathlessness Observational (RETRO) study : A prospective study using a mobile phone application
- 2019
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Ingår i: BMJ Open Respiratory Research. - : BMJ Publishing Group. - 2052-4439. ; 6:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Breathlessness, the subjective sensation of breathing discomfort, is common and appears in the daily life of people with cardiorespiratory diseases. Physicians often rely on patient's history based on symptom recall. The relation between recalled and experienced breathlessness is still poorly understood. This paper presents the protocol for a study primarily aimed at evaluating the relationship between experienced breathlessness and (1) recalled breathlessness and (2) predicted future breathlessness. Methods: A mobile phone application will be used to collect data during daily life. Medically stable participants, ≥18 years of age with mean daily breathlessness of Numerical Rating Scale (NRS) 3/10 and able to use a mobile phone with internet will rate their breathlessness intensity on a 0-10 NRS prompted the user several times daily for 1 week. Participants will recall their breathlessness each day and week. Multivariable random effects regression models will be used for statistical analyses. Results: Results of the study will be submitted for publication in peer-reviewed journals and presented at relevant conferences. Discussion: This protocol describes a study aimed at investigating previously unknown areas of the experience and recall of breathlessness using a new method of data collection. © 2019 Author(s).
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| 2. |
- Ekström, Magnus, et al.
(författare)
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Comorbidity and Sex-Related Differences in Mortality in Oxygen-Dependent Chronic Obstructive Pulmonary Disease
- 2012
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Ingår i: PLOS ONE. - : Public Library of Science. - 1932-6203. ; 7:4
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Tidskriftsartikel (refereegranskat)abstract
- Background: It is not known why survival differs between men and women in oxygen-dependent chronic obstructive pulmonary disease (COPD). The present study evaluates differences in comorbidity between men and women, and tests the hypothesis that comorbidity contributes to sex-related differences in mortality in oxygen-dependent COPD. Methods: National prospective study of patients aged 50 years or older, starting long-term oxygen therapy (LTOT) for COPD in Sweden between 1992 and 2008. Comorbidities were obtained from the Swedish Hospital Discharge Register. Sex-related differences in comorbidity were estimated using logistic regression, adjusting for age, smoking status and year of inclusion. The effect of comorbidity on overall mortality and the interaction between comorbidity and sex were evaluated using Cox regression, adjusting for age, sex, Pa-O2 breathing air, FEV1, smoking history and year of inclusion. Results: In total, 8,712 patients (55% women) were included and 6,729 patients died during the study period. No patient was lost to follow-up. Compared with women, men had significantly more arrhythmia, cancer, ischemic heart disease and renal failure, and less hypertension, mental disorders, osteoporosis and rheumatoid arthritis (P<0.05 for all odds ratios). Comorbidity was an independent predictor of mortality, and the effect was similar for the sexes. Women had lower mortality, which remained unchanged even after adjusting for comorbidity; hazard ratio 0.73 (95% confidence interval, 0.68-0.77; P<0.001). Conclusions: Comorbidity is different in men and women, but does not explain the sex-related difference in mortality in oxygen-dependent COPD.
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| 3. |
- Idrisoglu, Alper, et al.
(författare)
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COPDVD : Automated classification of chronic obstructive pulmonary disease on a new collected and evaluated voice dataset
- 2024
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Ingår i: Artificial Intelligence in Medicine. - : Elsevier. - 0933-3657 .- 1873-2860. ; 156
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundChronic obstructive pulmonary disease (COPD) is a severe condition affecting millions worldwide, leading to numerous annual deaths. The absence of significant symptoms in its early stages promotes high underdiagnosis rates for the affected people. Besides pulmonary function failure, another harmful problem of COPD is the systematical effects, e.g., heart failure or voice distortion. However, the systematic effects of COPD might provide valuable information for early detection. In other words, symptoms caused by systematic effects could be helpful to detect the condition in its early stages.ObjectiveThe proposed study aims to explore whether the voice features extracted from the vowel “a” utterance carry any information that can be predictive of COPD by employing Machine Learning (ML) on a newly collected voice dataset.MethodsForty-eight participants were recruited from the pool of research clinic visitors at Blekinge Institute of Technology (BTH) in Sweden between January 2022 and May 2023. A dataset consisting of 1246 recordings from 48 participants was gathered. The collection of voice recordings containing the vowel “a” utterance commenced following an information and consent meeting with each participant using the VoiceDiagnostic application. The collected voice data was subjected to silence segment removal, feature extraction of baseline acoustic features, and Mel Frequency Cepstrum Coefficients (MFCC). Sociodemographic data was also collected from the participants. Three ML models were investigated for the binary classification of COPD and healthy controls: Random Forest (RF), Support Vector Machine (SVM), and CatBoost (CB). A nested k-fold cross-validation approach was employed. Additionally, the hyperparameters were optimized using grid-search on each ML model. For best performance assessment, accuracy, F1-score, precision, and recall metrics were computed. Afterward, we further examined the best classifier by utilizing the Area Under the Curve (AUC), Average Precision (AP), and SHapley Additive exPlanations (SHAP) feature-importance measures.ResultsThe classifiers RF, SVM, and CB achieved a maximum accuracy of 77 %, 69 %, and 78 % on the test set and 93 %, 78 % and 97 % on the validation set, respectively. The CB classifier outperformed RF and SVM. After further investigation of the best-performing classifier, CB demonstrated the highest performance, producing an AUC of 82 % and AP of 76 %. In addition to age and gender, the mean values of baseline acoustic and MFCC features demonstrate high importance and deterministic characteristics for classification performance in both test and validation sets, though in varied order.ConclusionThis study concludes that the utterance of vowel “a” recordings contain information that can be captured by the CatBoost classifier with high accuracy for the classification of COPD. Additionally, baseline acoustic and MFCC features, in conjunction with age and gender information, can be employed for classification purposes and benefit healthcare for decision support in COPD diagnosis.
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| 4. |
- Jaworski, Jacek, et al.
(författare)
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Sources of breathing pattern variability in the respiratory feedback control loop
- 2019
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Ingår i: Journal of Theoretical Biology. - : Academic Press. - 0022-5193 .- 1095-8541. ; 469, s. 148-162
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Tidskriftsartikel (refereegranskat)abstract
- The variability of the breath-to-breath breathing pattern, and its alterations in disease, may hold information of physiologic and/or diagnostic value. We hypothesized that this variability arises from the way that noise is processed within the respiratory feedback control loop, and that pathologic alterations to specific components within the system give rise to characteristic alterations in breathing pattern variability. We explored this hypothesis using a computational model of the respiratory control system that integrates mechanical factors, gas exchange processes, and chemoreceptor signals to simulate breathing patterns subject to the influences of random variability in each of the system components. We found that the greatest changes in the coefficient of variation (CV) of both breathing amplitude and timing were caused by increases in lung resistance and impairments in gas exchange, both common features of pulmonary disease. This suggests that breathing pattern variability may reflect discernible deterministic processes involved in the control of breathing. © 2019 Elsevier Ltd
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| 5. |
- Plogmark, Oscar, et al.
(författare)
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Response to Metelkina and Barbaud
- 2023
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Ingår i: Diving and Hyperbaric Medicine. - : South Pacific Underwater Medicine Society and the European Underwater and Baromedical Society. - 1833-3516. ; 53:3
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 6. |
- Sandberg, Jacob, et al.
(författare)
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Comparing recalled versus experienced symptoms of breathlessness ratings : An ecological assessment study using mobile phone technology
- 2022
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Ingår i: Respirology (Carlton South. Print). - : John Wiley & Sons. - 1323-7799 .- 1440-1843. ; 27:10, s. 874-881
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Tidskriftsartikel (refereegranskat)abstract
- Background and objective: Recall of breathlessness is important for clinical care but might differ from the experienced (momentary) symptoms. This study aimed to characterize the relationship between momentary breathlessness ratings and the recall of the experience. It is hypothesized that recall is influenced by the peak (worst) and end (most recent) ratings of momentary breathlessness (peak-end rule). Methods: This study used mobile ecological momentary assessment (mEMA) for assessing breathlessness in daily life through an application installed on participants' mobile phones. Breathlessness ratings (0–10 numerical rating scale) were recorded throughout the day and recalled each night and at the end of the week. Analyses were performed using regular and mixed linear regression. Results: Eighty-four people participated. Their mean age was 64.4 years, 60% were female and 98% had modified Medical Research Council (mMRC) ≥ 1. The mean number of momentary ratings of breathlessness provided was 7.7 ratings/participant/day. Recalled breathlessness was associated with the mean, peak and end values of the day. The mean was most closely associated with the daily recall. Associations were strong for weekly values: peak breathlessness (beta = 0.95, r2 = 0.57); mean (beta = 0.91, r2 = 0.53); and end (beta = 0.67, r2 = 0.48); p < 0.001 for all. Multivariate analysis showed that peak breathlessness had the strongest influence on the breathlessness recalled at the end of the week. Conclusion: Over 1 week, recalled breathlessness is most strongly influenced by the peak breathlessness; over 1 day, it is mean breathlessness that participants most readily recalled. © 2022 The Authors. Respirology published by John Wiley & Sons Australia, Ltd on behalf of Asian Pacific Society of Respirology.
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| 7. |
- Silvanius, Mårten, et al.
(författare)
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The performance of 'temperature stick' carbon dioxide absorbent monitors in diving rebreathers
- 2019
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Ingår i: Diving and Hyperbaric Medicine. - : SOUTH PACIFIC UNDERWATER MED SOC. - 1833-3516 .- 2209-1491. ; 49:1, s. 48-56
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Diving rebreathers use canisters containing soda lime to remove carbon dioxide (CO2) from expired gas. Soda lime has a finite ability to absorb CO2. Temperature sticks monitor the exothermic reaction between CO2 and soda lime to predict remaining absorptive capacity. The accuracy of these predictions was investigated in two rebreathers that utilise temperature sticks. Methods: Inspiration and rEvo rebreathers filled with new soda lime were immersed in water at 19 degrees C and operated on mechanical circuits whose ventilation and CO2-addition parameters simulated dives involving either moderate exercise (6 MET) throughout (mod-ex), or 90 minutes of 6 MET exercise followed by 2 MET exercise (low-ex) until breakthrough (inspired PCO2 [PiCO2] = 1 kPa). Simulated dives were conducted at surface pressure (sea-level) (low-ex: Inspiration, n = 5; rEvo, n = 5; mod-ex: Inspiration, n = 7, rEvo, n = 5) and at 3-6 metres' sea water (msw) depth (mod-ex protocol only: Inspiration, n = 8; rEvo, n = 5). Results: Operated at surface pressure, both rebreathers warned appropriately in four o five low-ex tests but failed to do so in the 12 mod-ex tests. At 3-6 msw depth, warnings preceded breakthrough in 11 of 13 mod-ex tests. The rEvo warned conservatively in all five tests (approximately 60 minutes prior). Inspiration warnings immediately preceded breakthrough in six of eight tests, but were marginally late in one test and 13 minutes late in another. Conclusion: When operated at even shallow depth, temperature sticks provided timely warning of significant CO2 breakthrough in the scenarios examined. They are much less accurate during simulated exercise at surface pressure.
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| 8. |
- Skär, Lisa, 1964-, et al.
(författare)
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Thoughts on the end of life in patients with oxygen-dependent chronic obstructive pulmonary disease : A qualitative interview study
- 2023
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Ingår i: Nursing Open. - : John Wiley & Sons. - 2054-1058. ; 10:4, s. 2158-2164
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Tidskriftsartikel (refereegranskat)abstract
- Aim: The aim of the study was to deepen the current knowledge of how patients with chronic obstructive pulmonary disease and long-term oxygen treatment think about and expect end-of-life. Design: A qualitative design was used. Methods: A purposeful sample of 19 patients with oxygen-dependent chronic obstructive pulmonary disease was obtained from the Swedish National Registry on Respiratory Failure (Swedevox). Data was collected with semi-structured interviews and analysed using a hermeneutic approach. Results: The analysis revealed three themes: Living in the present without a future; difficulty talking about the uncertainty; and feeling anxious about leaving family behind. Participants indicated that healthcare professionals should invite them to mutual discussions as it was easier to reject an invitation if they could not talk right then, than to initiate a discussion themselves. Start of home oxygen or a deteriorating health status may be an important time to clinically address existential and end-of-life issues.
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| 9. |
- Stridsman, Caroline, et al.
(författare)
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Creating a balance between breathing and viability : Experiences of well-being when living with chronic obstructive pulmonary disease
- 2015
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Ingår i: Primary Health Care Research and Development. - 1463-4236 .- 1477-1128. ; 16:1, s. 42-52
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Tidskriftsartikel (refereegranskat)abstract
- Aim To describe experiences of well-being among people with moderate to very severe chronic obstructive pulmonary disease (COPD). BACKGROUND: Living with COPD is related to a complex life situation, and quality of life (QOL) is shown to decrease because of respiratory symptoms and fatigue. However, studies describing well-being in COPD as a subjective description of QOL are rare. METHODS: Ten participants with moderate to very severe COPD from the Obstructive Lung Disease in Northern Sweden (OLIN) COPD study were interviewed about their experiences of well-being. A latent qualitative content analysis was used to analyse the data. Findings To achieve well-being despite breathlessness, the participants had to adapt to their limitations and live towards the future. They created a balance between breathing and viability by adjusting to a lifelong limitation, handling variations in illness, relying on self-capacity and accessibility to a trustful care. The participants adjusted to lifelong limitations through acceptance and replacement of former activities. They handled variations in illness by taking advantage of the good days and using emotional adaptation strategies. The participants relied on their own self-capacity, feeling that smoking cessation, physical activity and breathing fresh air increased their well-being. They requested accessibility to a trustful care and highlighted the need for continuous care relationships and access to medications. These findings can enhance health-care professionals' understanding of the possibilities for increased well-being for people living with COPD.
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