I say IOS you say AOS: comparative bias in respiratory impedance measurements

Chris Kuo, Sunny Jabbal, Brian Lipworth (Lead / Corresponding author)

Research output: Contribution to journalArticlepeer-review

21 Citations (Scopus)
151 Downloads (Pure)


Background: The forced oscillation technique (FOT) measures respiratory impedance during normal tidal breathing and requires minimal patient cooperation.

Objective: To compare IOS and AOS devices in patients with asthma and COPD.

Methods: We compared two different FOT devices, namely impulse oscillometry using a loudspeaker (IOS: Jaeger Masterscreen) and airwave oscillometry using a vibrating mesh (AOS: Thorasys Tremoflo) for pre- and post-bronchodilator measurements in 84 patients with asthma and COPD.

Results: The overall pattern of measurement bias was for higher resistance with IOS and higher reactance with AOS, this being the case in asthma and COPD separately. There were small but significantly higher values using IOS for resistance at 5 Hz (R5) and 20(19) Hz (R20(19)). In converse, values for reactance at 5 Hz (X5), reactance area (AX) and resonant frequency (Fres) were significantly higher using AOS but to a much larger extent. The difference in AX between devices was more pronounced in COPD than in asthma. Salbutamol reversibility as % change was greater in asthma than COPD patients with AX but not FEV1.

Conclusion: Our study showed evidence of better agreement for resistance than reactance when comparing IOS and AOS, perhaps inferring that AOS may be more sensitive at measuring reactance in patients with airflow obstruction.
Original languageEnglish
Pages (from-to)473-481
Number of pages9
Issue number4
Early online date4 Jul 2019
Publication statusPublished - Aug 2019


  • Airwave oscillometry
  • Asthma
  • Asthma control questionnaire
  • COPD
  • Impulse oscillometry
  • Spirometry

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine


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