Box-Jenkins Transfer Function Modelling for Reliable Determination of VO2 Kinetics in Patients with COPD

Oxygen uptake (VO2) kinetics provide information about the ability to respond to the increased physical load during a constant work rate test (CWRT). Box-Jenkins transfer function (BJ-TF) models can extract kinetic features from the phase II VO2 response during a CWRT, without being affected by unwanted noise contributions (e.g., phase I contribution or measurement noise). CWRT data of 18 COPD patients were used to compare model fits and kinetic feature values between BJ-TF models and three typically applied exponential modelling methods. Autocorrelation tests and normalised root-mean-squared error values (BJ-TF: 2.8 +/- 1.3%; exponential methods A, B and C: 10.5 +/- 5.8%, 11.3 +/- 5.2% and 12.1 +/- 7.0%; p <0.05) showed that BJ-TF models, in contrast to exponential models, could account for the most important noise contributions. This led to more reliable kinetic feature values compared to methods A and B (e.g., mean response time (MRT), BJ-TF: 74 +/- 20 s; methods A-B: 100 +/- 56 s-88 +/- 52 s; p <0.05). Only exponential modelling method C provided kinetic feature values comparable to BJ-TF features values (e.g., MRT: 75 +/- 20 s). Based on theoretical considerations, we recommend using BJ-TF models, rather than exponential models, for reliable determinations of VO2 kinetics.