Incentivizing Spirometry: A Data Capture Device for Use with Incentive Spirometers. (Preprint)

BACKGROUND The incentive spirometer is a basic and common medical device from which electronic healthcare data cannot be directly collected. As a result, despite numerous studies investigating its utility in clinical care, there remains little consensus on optimal device utility and sparse evidence supporting its intended benefits such as prevention of postoperative respiratory complications. OBJECTIVE Develop a medical device to capture and use incentive spirometry data. METHODS We designed, built, and tested an add-on device using reflexive optical sensors to identify the real time location of the volume and flow pistons of the incentive spirometer. Data was simultaneously stored internally on the device and transmitted for collection and analysis. An algorithm was developed to determine breath quality to improve validity of data analysis. The device and algorithm were tested for data capture and labeling accuracy, respectively. Subsequently, we developed a cross platform video game for use with this device and tested using the Apple iPad. RESULTS The add-on device featured sensors mounted on the back of the incentive spirometer with an adjoining base containing electronics. Volume and flow piston locations were captured at 99% accuracy (+/- 1.4% SD) for volume and 100% accuracy for flow, while the breath algorithm displayed a 100% sensitivity and a 99% specificity. A custom video game operated in real time with Apple iPad devices. CONCLUSIONS Incentive spirometers are routinely used in hospitals, especially the postoperative period, but use recommendations lack thorough investigation partially due to a lack of data. We created and tested an effective and reusable add-on device for the incentive spirometer, allowing collection of previously inaccessible incentive spirometer data and demonstrating internet-of-things utility on a common hospital device. Spirometer data can facilitate research to improve adoption, guide clinical care, and incentivize adherence, to further investigate the clinical effectiveness of the incentive spirometer.