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Symmetric Projection Attractor Reconstruction: Analysis of waveform morphology predicts COPD exacerbations

M Serna Pascual, R D'Cruz, Y Huang, P Aston, C Jolley, G Rafferty, J Steier, M Nandi
European Respiratory Journal 2022 60: 3645; DOI: 10.1183/13993003.congress-2022.3645
M Serna Pascual
1Faculty of Life Sciences and Medicine, King’s College London, London, United Kingdom
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R D'Cruz
2Lane Fox Clinical Respiratory Physiology Research Unit, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom
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Y Huang
3Department of Mathematics, University of Surrey, Surrey, United Kingdom
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P Aston
3Department of Mathematics, University of Surrey, Surrey, United Kingdom
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C Jolley
1Faculty of Life Sciences and Medicine, King’s College London, London, United Kingdom
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G Rafferty
1Faculty of Life Sciences and Medicine, King’s College London, London, United Kingdom
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J Steier
2Lane Fox Clinical Respiratory Physiology Research Unit, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom
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M Nandi
1Faculty of Life Sciences and Medicine, King’s College London, London, United Kingdom
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Abstract

Background: Respiratory pattern analysis is currently reduced to simplified biomarkers, such as rate. However, respiratory waveforms are complex and generally sampled with high fidelity. Our novel mathematical method, Symmetric Projection Attractor Reconstruction (SPAR) analyses the morphology and variability of such waveforms, without discarding any data.

Aims and objectives: To investigate whether SPAR can detect changes in respiratory waveforms that better predict impending COPD exacerbations.

Methods: Retrospective nasal pressure data, recorded during resting tidal breathing, were analysed from 10 COPD patients who were home monitored daily following hospital discharge, after an exacerbation.

Results: Over the 30 days of monitoring 4 patients re-exacerbated and 6 remained stable. SPAR transformations highlighted differences in waveform morphology between these two patient groups (Fig. 1). Statistically, SPAR measures outperformed respiratory rate in discriminating between groups at hospital discharge (ROC AUC 0.95 vs. 0.90) and throughout the monitoring period (ROC AUC 0.98 vs. 0.83).

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Conclusions: SPAR provided supplementary, early evidence identifying patients who re-exacerbated. We predict that a combination of SPAR plus conventional measures may support clinical decision making at hospital discharge and during community monitoring, providing an earlier alert for patients, carers and clinical teams.

  • COPD - diagnosis
  • COPD - exacerbations
  • Monitoring

Footnotes

Cite this article as Eur Respir J 2022; 60: Suppl. 66, 3645.

This article was presented at the 2022 ERS International Congress, in session “-”.

This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).

  • Copyright ©the authors 2022
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Symmetric Projection Attractor Reconstruction: Analysis of waveform morphology predicts COPD exacerbations
M Serna Pascual, R D'Cruz, Y Huang, P Aston, C Jolley, G Rafferty, J Steier, M Nandi
European Respiratory Journal Sep 2022, 60 (suppl 66) 3645; DOI: 10.1183/13993003.congress-2022.3645

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Symmetric Projection Attractor Reconstruction: Analysis of waveform morphology predicts COPD exacerbations
M Serna Pascual, R D'Cruz, Y Huang, P Aston, C Jolley, G Rafferty, J Steier, M Nandi
European Respiratory Journal Sep 2022, 60 (suppl 66) 3645; DOI: 10.1183/13993003.congress-2022.3645
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