@article {DevotP2149, author = {Sandrine Devot and Ren{\'e} Derkx and Jakob Van der Laar and Eui-Sik Suh and Nicholas Hart}, title = {An automated algorithm to calculate neural respiratory drive (NRD) from the parasternal electromyogram (EMG) in patients with an acute exacerbation of COPD (AECOPD)}, volume = {44}, number = {Suppl 58}, elocation-id = {P2149}, year = {2014}, publisher = {European Respiratory Society}, abstract = {Background: NRD, as derived from 2nd intercostal space parasternal electromyography (EMGpara), has been shown previously to identify patients at risk of clinical deterioration (Murphy et al, Thorax, 2011). However, its use as an advanced physiological biomarker is limited as inspiratory EMGpara signals require breath-by-breath analysis by an experienced physiologist. We hypothesised that an automated algorithm would produce comparable results to labour-intensive manual analysis in quantifying NRD.Methods: AECOPD patients admitted to a large university hospital had EMGpara and airflow measurements daily from admission to discharge, at 1-month post discharge and at 3-month follow-up. 1-minute segments for each recording underwent manual and automated analyses. Mean inspiratory EMGpara signals were reported in microvolts ({\textmu}V) and Bland-Altman analysis performed.Results: 120 patients were recruited (age=70{\textpm}9 years, FEV1=30.5{\textpm}11.2\% predicted) and 688 recordings were analysed. The Bland-Altman method shows a bias of 0.0 {\textmu}V and limits of agreement of {\textpm}2.9 {\textmu}V, with 109 recordings where the algorithm did not return any output, mostly due to the failure to detect inspiratory phases in specific recordings with poor airflow signal quality (reference EMGpara=11.8{\textpm}6.9 {\textmu}V, automated EMGpara=11.8{\textpm}6.8 {\textmu}V).Conclusion: Automated NRD calculation shows acceptable level of accuracy as compared against the manual reference scoring. These data support the feasibility of implementing EMGpara as an automated system in clinical practice. However, further prospective validation of the algorithm is required to confirm its clinical utility.}, issn = {0903-1936}, URL = {https://erj.ersjournals.com/content/44/Suppl_58/P2149}, eprint = {https://erj.ersjournals.com/content}, journal = {European Respiratory Journal} }