Oscillometry: An underutilized yet conclusive tool

ERT |

August 19, 2021

As a leader in digital data solutions, ERT recognizes the importance of continuous learning and innovation within the industry to serve our customers best. As such, we regularly host webinar sessions led by experts in various therapeutic areas to educate stakeholders in the clinical trial industry.

ERT recently hosted a webinar featuring two industry leaders who took a deeper look into the theory and usage of Airwave Oscillometry (AOS), also known as Forced Oscillation Technique (FOT). U.K.-based Philip Lake, Ph.D., Senior Director, Respiratory Solutions at ERT, and Montreal-based Lennart Lunblad, Ph.D., Director Clinical Science, Thorasys Thoracic Medical Systems Inc., discussed the uses of oscillometry in clinical trials and the potential for oscillometry-based endpoints to augment or replace traditional lung function endpoints to better understand the impact of new medicines.

Dr. Lake and Dr. Lunblad began their discussion by comparing oscillometry and spirometry. Despite the wide acceptance of spirometry in clinical trials, there are several obstacles and shortcomings surrounding its use for patient assessment and diagnosis. Oscillometry, they agreed, is an underutilized tool.

The most significant difference between the two is oscillometry requires less patient dependence. The device assesses the patient’s pulmonary function during quiet, tidal breathing by superimposing a gentle, multi-frequency oscillation on top of the patient’s natural breathing. Reduced sensitivity to the patient’s technique, position, and effort make testing easily repeatable and leaves little variability between patients. These factors enable reliable, quality outcomes, making the tool suitable for drug studies with large patient populations and smaller studies focusing on sensitive changes in the small airways. Oscillometry is especially beneficial in pediatrics, where the level of variability can be extreme due to inconsistent techniques used by younger patients.

Still, Dr. Lunblad stated both oscillometry and spirometry are beneficial as long as scientists and researchers understand the uses and limitations of each device. The tools are valuable at measuring different aspects of the lung. Oscillometry indicates how small airways are operating, while spirometry looks at large airways and can provide the speed of exhale.

Lung diseases are complex and manifest in several different ways. Oscillometry is highly sensitive to picking up changes in the lung, but historically, the data was difficult to interpret. Over time, scientists have come to understand how to interpret improvements in the lungs through pattern recognition. Dr. Lunblad stated the two strongest candidates for endpoints are airway resistance, which indicates small airway obstruction and heterogeneous or homogeneous ventilation in the lung, and reactance, which provide a measurement of the elasticity of the lung and ventilation defects.

Oscillometry shows how the drug impacts the lungs, thus validating the data and determining a drug worth developing for small airways and improvements, said Dr. Lake. Conversations such as these propel the industry forward and provide customers, sites, and patients with new solutions for improved lives. The conversation also covered using oscillometry to detect how medications damage the lungs, using changes in lung function as a biomarker for disease progression, and the ability for sites to use the device without previous experience.

Click here to listen to the full conversation.

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