Validation of exhaled volatile organic compounds analysis using electronic nose as index of COPD severity
Received 12 December 2017
Accepted for publication 25 January 2018
Published 1 May 2018 Volume 2018:13 Pages 1441—1448
Checked for plagiarism Yes
Review by Single-blind
Peer reviewer comments 2
Editor who approved publication: Dr Richard Russell
Panaiotis Finamore,1 Claudio Pedone,1 Simone Scarlata,1 Alessandra Di Paolo,1 Simone Grasso,2 Marco Santonico,2 Giorgio Pennazza,2 Raffaele Antonelli Incalzi1
1Unit of Geriatrics, Campus Bio-Medico di Roma University, Rome, Italy; 2Unit of Electronics for Sensor Systems, Campus Bio-Medico di Roma University, Rome, Italy
Aim: Six-minute walking test distance (6MWD) and body mass index, obstruction, dyspnea and exercise (BODE) index are measures of functional status in COPD patients, but require space, time and patient’s compliance. Exhaled volatile organic compounds (VOCs) analysis via electronic nose is a quick and easy method that has already been used to discriminate COPD phenotypes. The aim of this study is to evaluate whether VOCs analysis can predict functional status and its variation over time in COPD patients.
Methods: A monocentric prospective study with 1 year of follow-up was carried out. All patients underwent pulmonary function tests, arterial gas analysis, bioimpedance analysis, 6-minute walking test, and VOCs collection. Exhaled breath was collected with Pneumopipe® and analyzed using BIONOTE electronic nose. Outcomes prediction was performed by k-fold cross-validated partial least square discriminant analysis: accuracy, sensitivity and specificity as well as Cohen’s kappa for agreement were calculated.
Results: We enrolled 63 patients, 60.3% men, with a mean age of 71 (SD: 8) years, median BODE index of 1 (interquartile range: 0–3) and mean 6MWD normalized by squared height (n6MWD) of 133.5 (SD: 42) m/m2. The BIONOTE predicted baseline BODE score (dichotomized as BODE score <3 or ≥3) with an accuracy of 86% and quartiles of n6MWD with an accuracy of 79%. n6MWD decline more than the median value after 1 year was predicted with an accuracy of 86% by BIONOTE, 52% by Global Initiative for Chronic Obstructive Lung Disease (GOLD) class and 78% by combined BIONOTE and GOLD class.
Conclusion: Exhaled VOCs analysis identifies classes of BODE and n6MWD quartiles, and outperforms GOLD classification in predicting n6MWD variation.
Keywords: volatile organic compounds, electronic nose, 6-minute walking test, COPD, functional status, BODE index