Saudi Cultural Missions Theses & Dissertations
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Item Restricted Evaluating FEV1Q as a race-neutral measurement of lung function across three diverse populations in LMICs.(University College London (UCL), 2024-08-28) ALlayadhi, Ayadh; Hurst, JohnIntroduction The adjustment of lung function for ethnicity is controversial and has led to race-neutral approaches, such as forced expired volume in 1st second quotient (FEV1Q), which expresses FEV1 as a multiple of the theoretical lower limit of survival. It is unknown whether this lower limit is similar in diverse populations in different low- and middle-income countries (LMICs) or whether FEV1Q can accurately diagnose chronic obstructive pulmonary disease (COPD). This study aimed to evaluate the FEV1Q as a race-neutral measure of lung function in these regions. Methods This study utilised 10660 participants’ spirometry and anthropometric data, aged ≥40 years, collected from Uganda, Nepal, and Peru, with even sex and site distribution. The assessment included: whether 1st percentiles of absolute FEV1 were similar across these populations, assessing the FEV1Q diagnostic ability for 999 COPD cases, and estimating FEV1Q decline rates under several circumstances. Results The 1st percentiles of absolute FEV1 (L) were similar to the previously reported values of 0.5 L for males and 0.4 L for females in the COPD group, while these percentiles differed in the entire population. FEV1Q had discriminative accuracy in diagnosing COPD (AUC = 0.87). Estimation of FEV1Q decline under normal conditions demonstrated 1 unit/18 years, while it declined every 12.5 years for current smokers and every 17.5 years with biomass exposure. Discussion Although this study addressed the lack of diverse populations in which FEV1Q has been assessed, and presented several strengths, it did not include follow-up measurements of lung function which limit quantifying long-term outcomes; and ethnicity/race categories were assumed based on site. This highlights the need for future longitudinal studies to assess FEV1Q utility, and shed light on other respiratory conditions. Conclusion FEV1Q is a simple and promising race-neutral measure of lung function; however, further studies are required.13 0Item Restricted Detection of Dysfunctional Breathing Using Structured Light Plethysmography(Saudi Digital Library, 2023-09-28) Alhuthail, Eyas; Coney, Andrew; Cooper, BrendanDysfunctional breathing (DB) is a term often used to describe irregularities of breathing in patients. In practice, the detection of DB is primarily subjective in nature, with focus on questionnaires and physical examination that can be influenced by personal judgment. Development of new techniques and approaches to allow the quantification of DB is required. This thesis introduced the use of Structured Light Plethysmography (SLP) in the detection of dysfunctional breathing and exploring the variability that exists in normal breathing patterns. SLP provides the assessment of tidal breathing pattern measures while allowing measurements to be made in different positions due to it being mobile and flexible. In the first study, SLP demonstrated reproducible results when repeated on different occasions. DB patterns present with changes in breathing patterns, and SLP correlated well with these, albeit some differences in rapid shallow breathing. The second study focused on the development of an entropy measurement that quantifies the variability in breathing patterns. Patients with a restrictive condition showed a more controlled breathing pattern, whereas in obstructive patients, the entropy varied with body position. The last study was focused on the assessment of changes in breathing patterns of post-COVID-19 patients from ward and ITU units compared to healthy subjects; this has shown a persistent mild restrictive pattern approximately 3 months after discharge without a significant change in the entropy of breathing, suggesting some long term effects of hospitalisation due to COVID-19. The overall outcome allowed for the use of SLP in different positions and demonstrated the ability to detect different breathing patterns and the suitability of entropy analysis to be applied to the data acquired, showing another measure of variability. With further investigation, analysis of the variability of breathing patterns may be an additional tool to help understand DB.38 0