PT - JOURNAL ARTICLE AU - Meera Kamalanathan AU - Rachel Harding AU - Laura Swanton AU - Swapna Mandal AU - Eui-Sik Suh AU - John Moxham AU - Nicholas Hart TI - Reproducibility and reliability of parasternal electromyography in patients with COPD and obesity related respiratory failure (ORRF) DP - 2013 Sep 01 TA - European Respiratory Journal PG - P1916 VI - 42 IP - Suppl 57 4099 - http://erj.ersjournals.com/content/42/Suppl_57/P1916.short 4100 - http://erj.ersjournals.com/content/42/Suppl_57/P1916.full SO - Eur Respir J2013 Sep 01; 42 AB - Background: 2nd intercostal space parasternal electromyography (EMGpara) as a physiological biomarker of neural respiratory drive (NRD) may detect clinical change in patients with COPD and obesity (Murphy et al, Thorax 2011; Steier et al, Thorax 2009). There are limited data demonstrating the reproducibility and interobserver reliability of EMGpara measurements in the stable COPD and ORRF population. We hypothesised that EMGpara would be reproducible between 2 separate occasions in stable patients and that there would be satisfactory interobserver reliability in the analysis of EMGpara. Methods: Patients with COPD and ORRF underwent 10 minutes of EMGpara measurement on two separate occasions, 7 days apart. 1 minute of EMGpara signals was analysed for each trace by an expert and novice. NRD was expressed as EMGpara%max (mean inspiratory EMGpara signal over 1 minute, normalised to a maximum signal measured during a sniff manoeuvre). Inter-occasion and inter-rater reliability were calculated using intra class coefficient (ICC). Results: 14 patients were recruited, 7 COPD & 7 ORRF. COPD group: 71±7 years, 85% male, body mass index (BMI) 31.2±9.1kg/m2. ORRF group: 64±6 years, 71% male, BMI 46.2±5.4kg/m2. In the COPD group (n=7), expert analysis inter-occasion ICC = 0.80; expert-novice inter-rater ICC = 0.94. ORRF group (n=7), expert analysis inter-occasion ICC = 0.763; expert-novice inter-rater ICC = 0.739. Conclusion: NRD measured using EMGpara has acceptable levels of reproducibility and interobserver reliability in stable patients with COPD and ORRF. These data support the clinical usefulness of EMGpara as a non-invasive advanced physiological marker.