Specialist commentator comments

Comments on this technology were invited from specialists working in the field and relevant patient organisations. The comments received are individual opinions and do not represent NICE's view.

All 4 specialist commentators were familiar with the technology and 2 of the 4 had used it before, both noting they have further unpublished research data on the device.

Level of innovation

The specialist commentators generally agreed that the device is innovative, noting that other systems and devices were available to measure tidal breathing parameters, but none did so in the non-invasive, accessible way that Thora‑3Di does.

Potential patient impact

Three specialist commentators said the device had potential in the management of disabled people such as those with neuromuscular disorders who could not perform a standard lung function. One said the ability to measure right-versus-left lung function would be a major advantage in conditions such as scoliosis. All the specialist commentators noted Thora‑3Di's advantages in not needing specific respiratory manoeuvres, so being able to measure breathing factors in the very old and young and other people who find conventional spirometry difficult. One noted it does not need a mask or mouthpiece to be used and does not interfere with normal breathing.

Potential system impact

The specialist commentators commented that changes to the patient pathway were possible but would need significant further clinical studies to determine the place in therapy. One noted that there was not enough data to suggest that Thora‑3Di should replace spirometry.

One specialist commentator said if more data on healthy patients were collected, it could improve the objective measurement of breathing parameters. In turn, this could potentially contribute to a significant improvement in patient outcome. One said there was not sufficient evidence to use Thora‑3Di over existing clinical monitoring and diagnosis techniques.

General comments

Two specialist commentators commented that the technology could have advantages over spirometry as Thora‑3Di as it is easier to interpret and quicker to learn, but one cautioned that there is no published evidence on the training for Thora‑3Di. Two specialist commentators commented on the large upfront costs of the device and noted the savings in staff time over spirometry may not be realised in the patient groups likely to benefit the most as the patients are required to change into a white t-shirt and to stay still for several minutes. Two specialist commentators noted that the use a dedicated room to house the machine and do the test may limit use, especially in primary care. All experts said the device has potential to be applied to a very large population of people with asthma but all agreed further research evidence on larger populations and comparison with other methods of diagnosis and monitoring were needed.