Reproducibility of nasal peak inspiratory flow among healthy adults - Assessment of epidemiologic utility

Study objective: To assess the reproducibility of nasal peak inspiratory flow Participants: Twelve healthy nonsmoking volunteers were studied. Methods: Repeated measurements of PIFn and oral (PIFm) peak inspiratory flow were performed for 5 consecutive days. Two methods of inhalation were compared. In the residual volume (RV) method, the forced maximal inspiratory maneuver was initiated from the end of a maximal expiration, while in the functional residual capacity (FRC) method, the maneuver was from the end of a tidal breath. Reproducibility was assessed by the intraclass correlation coefficient. Time trend for the 5 days was assessed by random effect models adjusting for different baseline for each subject. Results: The intraclass correlation coefficient (ICC) of PIFn was 0.89 (lower limit of one-sided 95% confidence interval is 0.80) by the RV method and 0.78 (95% lower limit is 0.63) by the FRC method, suggesting that both methods have good reproducibility. These were similar to the ICCs of PIFm by each method. The FRC method did not show a significant time trend for PIFn. The RV method had a small, but significant, decreasing time trend of a magnitude considered inconsequential for the purpose of epidemiologic study. Conclusion: PIFn, measured from either RV or from FRC, showed good reproducibility and can be employed in epidemiologic studies investigating the upper airways' response to air pollutant exposure. Further studies of the relationships between PIFn and signs and symptoms of rhinitis are needed to evaluate the utility of this test for clinical and epidemiologic use.