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From the Authors

Dept of Pediatric Respiratory Diseases, University Medical Center, Utrecht, the Netherlands

From the authors:

We thank I. Steenbruggen and R.J. Roorda for their attention and comments on our article on the use of computer animation programs during maximal expiratory flow volume (MEFV) measurements in young children 1. We were also surprised by our finding that the use of the programs did not improve maximal effort. As paediatricians we always think that "toys are good for children". However, our data show that MEFV measurements require serious effort and that "toys are no good for the results".

In our study the use of the incentive was always accompanied by the same coaching by the same lung function technician. Our findings of less performance on forced vital capacity with use of the incentives were significant and very consistent for both programs (balloons and candles), for both younger and older children and for both children with and without experience. Because I. Steenbruggen and R.J. Roorda do not present any data on their findings we cannot rule out whether their lack of significant findings was merely a power problem or not.

MEFV measurements are only reproducible when the performance is really maximal, i.e. when flow limitation is achieved. Sub-optimal MEFV performance will therefore always be accompanied by a loss of reproducibility, as was observed in our patients.

We agree that children find the lung function test more attractive with use of the programs. This was also observed by Nystad et al. 2. So our message is: "first play the game and then do the job" (or the other way round), but do not try to do them together.

References

1. Gracchi V, Boel M, Van der Laag J, Van der Ent CK. Spirometry in young children: should computer-animation programs be used during testing?. Eur Respir J 2003;21:872–875.[Abstract/Free Full Text]
2. Nystad W, Samuelsen SO, Nafstad P, Edvardsen E, Stensrud T, Jaakkola JJ. Feasibility of measuring lung function in preschool children. Thorax 2002;57:1021–1027.[Abstract/Free Full Text]

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Permissions Request Permissions Services Email this article to a friend Similar articles in this journal Similar articles in Web of Science Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Gracchi, V. Articles by van der Ent, C.K. Search for Related Content PubMed Articles by Gracchi, V. Articles by van der Ent, C.K.