(a) discrimination between health and disease
ULN based on 75 healthy controls from a retrospective dataset1 was lower in Spiroware 3.3.1 with LCI 7.1 compared to 8.1 in 3.2.1. Sensitivity was comparable (77.8% (3.2.1) and 76.2% (3.3.1)) and specificity identical (98.7%) between 3.2.1 and 3.3.1 with some scatter in the critical area (Figure 1, Supplemental Figure 2) based on natural variability. In Spiroware 3.3.1, two children with CF had abnormal LCI values compared to normal values in 3.2.1, while one healthy child was falsely categorized as abnormal based on slightly elevated LCI. In both Spiroware versions LCI values of all the other healthy controls were within normal range and 15 children with CF had values below the ULN.