Forced oscillation, integer and fractional-order modeling in asthma

The purpose of this study was to evaluate the use of fractional-order (FrOr) modeling in asthma. To this end, three FrOr models were compared with traditional parameters and an integer-order model (InOr). We investigated which model would best fit the data, the correlation with traditional lung function tests and the contribution to the diagnostic of airway obstruction. The data consisted of forced oscillation (FO) measurements obtained from healthy (n = 22) and asthmatic volunteers with mild (n = 22), moderate (n = 19) and severe (n = 19) obstructions. The first part of this study showed that a FrOr was the model that best fit the data (relative distance: FrOr = 4.3 +/- 2.4; InOr = 5.1 +/- 2.6%). The correlation analysis resulted in reasonable (R = 0.36) to very good (R = 0.77) associations between FrOr parameters and spirometry. The closest associations were observed between parameters related to peripheral airway obstruction, showing a clear relationship between the FrOr models and lung mechanics. Receiver-operator analysis showed that FrOr parameters presented a high potential to contribute to the detection of the mild obstruction in a clinical setting. The accuracy [area under the Receiver Operating Characteristic curve (AUC)] observed in these parameters (AUC = 0.954) was higher than that observed in traditional FO parameters (AUC = 0.732) and that obtained from the InOr model (AUC = 0.861). Patients with moderate and severe obstruction were identified with high accuracy (AUC = 0.972 and 0.977, respectively). In conclusion, the results obtained are in close agreement with asthma pathology, and provide evidence that FO measurement associated with FrOr models is a non-invasive, simple and radiation-free method for the detection of biomechanical abnormalities in asthma. (C) 2016 Elsevier Ireland Ltd. All rights reserved.