The effect of physiologic and mechanical aging on the performance of peak flowmeters.

PURPOSE To investigate the effects of physiologic and mechanical aging on peak flowmeters. MATERIALS AND METHODS Eight each of MiniWright (MW; Clement Clark; Harlow, UK), Personal-Best (PB; HealthScan Products; Cedar Grove, NJ), Vitalograph (V; Vitalograph Ltd; Buckingham, UK), and Breath-Taker (BT; Medical Development Australia; Melbourne, Australia) peak flowmeters were assessed for accuracy and repeatability before and after aging using a computer-driven syringe to deliver peak flows from 100 to 700 L/min. Four of each type of flowmeter were physiologically aged by normal subjects performing up to six peak flows daily for 1 year. The remaining four of each flowmeter were mechanically aged using an accelerated aging device to deliver 2,000 exponential waveforms with a peak flow of 600 L/min over a period of 3 h. RESULTS The V and BT flowmeters were linear and accurate over the range 100 to 700 L/min, while the PB overread at high flows. The MW was alinear throughout. The SD of the difference between readings before and after aging ranged from 8.6 to 40.6 L/min (mean, 9.2). Comparing the slopes of the relationship of actual against reference peak expiratory flow (PEF) showed that 16 flowmeters--5 BTs, 6 MWs, 4 PBs, and 1 V had no significant change in slope after aging. Mechanical aging caused a consistent underreading in PEF at high flow rates. Physiologic aging showed a more variable pattern both within and between flowmeter types. The MW was the most affected by physiologic aging, producing overestimates of PEF by as much as 100 L/min at 500 L/min. CONCLUSIONS We conclude that the effects of physiologic and mechanical aging are different, and that while mechanical aging may provide a guide to the effects of aging, studies using physiologic aging would be more appropriate.