Methods by which patients can artificially produce raised peakflow measurements have been described. We recently observed a patientmanipulating the peak flow meter in a way that had not been describedbefore. A study was therefore undertaken to determine if this techniquecould repeatedly produce clinically significant changes in peak flowreadings. Fifteen adults, using a mini-Wright peak flow meter, madefive measurements using the correct technique followed by fivemanipulated measurements under observation. Significant increases inpeak flow measurements were observed in 14 of the 15 subjects. The meanincrease in peak flow rate using the incorrect technique was 56%(range -4% to 86%). Clinicians should be aware that patients mightemploy this technique to manipulate measurements which could haveconsequences for management.
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