Abstract:
The present disclosure relates to an electronic spirometer that empowers users to quantitatively track and proactively manage respiratory diseases via simple integration with mobile devices, tablets, and computers. In one aspect, patients will be able to connect with their doctors to determine medication dosage and efficacy, avoid environmental triggers, and prevent attacks and exacerbations.

Description:
CROSS-REFERENCE TO RELATED APPLICATIONS 
       [0001]    The present application is a divisional of U.S. patent application Ser. No. 13/900,253, filed May 22, 2013, which claims the benefit of and priority from U.S. Provisional Patent Application No. 61/650,122, filed May 22, 2012, entitled “Spirometer and Methods of Data Analysis,” and to U.S. Provisional Patent Application No. 61/732,065, filed Nov. 30, 2012, entitled “Spirometer,” all of which are incorporated herein, in their entireties, by reference. 
     
    
     FEDERALLY SPONSORED RESEARCH OR DEVELOPMENT 
       [0002]    Not Applicable. 
       COMPACT DISK APPENDIX 
       [0003]    Not Applicable. 
       FIELD OF THE DISCLOSURE 
       [0004]    The present invention related generally to a spirometer. More specifically, the present invention relates to a hand-held spirometer having a fluidic oscillator. 
       BRIEF SUMMARY 
       [0005]    The present disclosure relates to systems and methods for measuring airflow, which may be used to monitor or assess respiratory function. In various embodiments, the system includes a flow meter, such as a spirometer in communication with a computing device executing one or more applications to process and analyze data generated at the spirometer. 
         [0006]    In one embodiment, a device for measuring a continuous flow rate of an airstream includes a nozzle having at least one channel to vent a portion of the airstream into an environment external to the device and at least one other channel to direct another portion of the airstream into a fluidic oscillator. The device also includes a fluidic oscillator having a housing and at least one obstacle to induce oscillations in the airstream. A frequency of the oscillations correlates to the continuous flow rate of the airstream. The device also includes at least one sensor to measure the oscillations of the airstream. The at least one sensor also generates an electronic signal corresponding to the oscillations measured and transmits the electronic signal to a computing device. 
         [0007]    In another embodiment, a device for measuring a continuous flow rate of an air stream includes a nozzle to direct a portion of the airstream into a fluidic oscillator. The device also includes a detachable mouthpiece to reduce back pressure within the device. The detachable mouthpiece has a diameter equal to the diameter of the nozzle and defines a plurality of channels. At least one of the plurality of channels directs a portion of the airstream to the nozzle while, at least one other channel vents another portion of the airstream to an environment external to the device. The device also includes a fluidic oscillator having a housing and at least one obstacle to induce oscillations in the airstream. A frequency of the oscillations correlates to the continuous flow rate of the airstream. The device also includes at least one sensor to measure the oscillations of the airstream. The at least one sensor also generates an electronic signal corresponding to the oscillations measured and transmits the electronic signal to a computing device. 
         [0008]    A flow meter system for monitoring lung function of a user includes an oscillation chamber to induce at least one oscillation in an airflow traversing the oscillation chamber. The airflow is generated by the user during a respiratory test. The system also includes at least one sensor to measure the rate of oscillation in the oscillation chamber and transmit a data signal to a computing device. The computing device has at least one processor and receives the data signal. The computing device also processes the data signal to determine at least one of a flow rate, time duration, or a volume of the airflow in the oscillation chamber. The system further includes a display device in communication with the computing device to display an assessment of respiratory health and a risk level to the user. 
         [0009]    A system for monitoring lung function of a user includes at least one processor, at least one data storage device and an application executing on the at least one processor to determine spirometric characteristics of a data signal received from a spirometer. The data signal is generated in response to at least one oscillation of an airflow in the spirometer. The system also generates at least one display on a display device to display the spirometric characteristics and generates at least one risk level assessment. 
         [0010]    The present disclosure also relates to various methods for measuring airflow and monitoring lung function. The methods may be performed using various embodiments of the devices and systems disclosed herein. The methods may also be performed with other suitable devices and systems. 
     
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         [0011]      FIG. 1  is a perspective view of a first end of a spirometer device according to one embodiment. 
           [0012]      FIG. 2  is a perspective view of a second end of the spirometer device according to one embodiment. 
           [0013]      FIG. 3  is a side plan view of the spirometer device according to one embodiment. 
           [0014]      FIG. 4  is a cross-sectional view of the spirometer device of  FIG. 3 , taken along line A-A, according to one embodiment. 
           [0015]      FIG. 5  is a top plan view of the spirometer device according to one embodiment. 
           [0016]      FIG. 6  is a plan view of the first end of the spirometer device according to one embodiment. 
           [0017]      FIG. 7  is a perspective view of a first end of a spirometer mouthpiece according to one embodiment. 
           [0018]      FIG. 8  is a perspective view of a second end of the spirometer mouthpiece according to one embodiment. 
           [0019]      FIG. 9  is a side plan view of an embodiment of the spirometer mouthpiece according to one embodiment. 
           [0020]      FIG. 10  is a cross-sectional view of the spirometer mouthpiece of  FIG. 9 , taken along line B-B, according to one embodiment. 
           [0021]      FIG. 11  is a top plan view of the spirometer mouthpiece according to one embodiment. 
           [0022]      FIG. 12  is a plan view of the first end of the spirometer mouthpiece according to one embodiment. 
           [0023]      FIG. 13  is a perspective view of a spirometer mouthpiece according to one embodiment. 
           [0024]      FIG. 14  is an end view of the spirometer mouthpiece of  FIG. 13  according to one embodiment. 
           [0025]      FIG. 15  is a top plan view of the spirometer mouthpiece of  FIG. 13  according to one embodiment. 
           [0026]      FIG. 16  is a perspective view of a first end of a spirometer device having an integrated mouthpiece according to one embodiment. 
           [0027]      FIG. 17  is a perspective view of a second end of a spirometer device having an integrated mouthpiece according to one embodiment. 
           [0028]      FIGS. 18A-C  are top plan views of other embodiments of the spirometer device. 
           [0029]      FIG. 19  is a perspective view of a spirometer device disengaged from a modular sensor housing according to one embodiment. 
           [0030]      FIG. 20  is a perspective view of a modular sensor housing according to one embodiment. 
           [0031]      FIG. 21  is a cross-sectional view of the modular sensor housing of  FIG. 17  taken along the line C-C, according to one embodiment. 
           [0032]      FIG. 22  is a top plan view of a spirometer device engaged with a modular sensor housing according to one embodiment. 
           [0033]      FIG. 23  is a perspective view of a bi-directional spirometer device according to one embodiment. 
           [0034]      FIG. 24  is a top plan view of a stacked bi-directional spirometer device according to one embodiment. 
           [0035]      FIG. 25  is a side plan view of the stacked bi-directional spirometer device of  FIG. 24 , according to one embodiment. 
           [0036]      FIG. 26  is a block diagram of a system and computing environment for collecting and analyzing spirometric data according to one embodiment. 
           [0037]      FIG. 27  is a block diagram depicting a signal-processing method for analyzing data from a spirometer device according to one embodiment. 
           [0038]      FIG. 28  is a block diagram depicting a signal-processing method for analyzing data from a spirometer device according to one embodiment. 
           [0039]      FIG. 29  is a block diagram depicting a signal-processing method for analyzing data from a spirometer device according to one embodiment. 
           [0040]      FIG. 30  is a block diagram depicting a method for calibrating a spirometer device according to one embodiment. 
           [0041]      FIG. 31  is an embodiment of a spirometry application, executable on a computing device, according to one embodiment. 
           [0042]      FIG. 32  depicts a user interface generated on a tablet by the spirometry application according to one embodiment. 
           [0043]      FIGS. 33-34  depict user interfaces generated on smartphones by the spirometry application according to one embodiment. 
       
    
    
     DETAILED DESCRIPTION 
       [0044]    The present disclosure generally relates to a low-cost spirometer device and software system executing on a computing device to perform analysis of a user&#39;s respiratory function. The software system may perform analysis on a data signal generated at the spirometer and provide guidance and feedback to the user. 
         [0045]    In various embodiments, a user of the spirometer may exhale and/or inhale through the device. Each exhalation or inhalation through the device may be referred to as a spirometric maneuver. In one aspect, each spirometric maneuver will have characteristics that are detected by a sensor of the device. The data signal generated by the sensor may then be transmitted to a computing device for signal processing and analysis. In various embodiments, the data signal may contain information pertaining to one or more spirometric maneuvers. 
         [0046]      FIGS. 1 and 2  are perspective views of one embodiment of the spirometer  100 . As shown, this embodiment of the spirometer  100  includes a fluidic oscillator  102  that is at least partially defined by a housing  104 , a mouthpiece  130  and a sensor  150 . Although described and shown as being integrated with the housing  104 , in other embodiments, the fluidic oscillator  102  may be contained within a separate housing or environment. 
         [0047]    In one aspect, the fluidic oscillator  102  is defined, at least in part, by the housing  104  to provide two or more pathways or side channels  106 A-B for air traveling through the oscillator. The pathways  106 A-B are separated by an obstacle  108 . In one embodiment, as shown in  FIGS. 4 and 5 , the obstacle  108  is generally heart-shaped. In this embodiment, an airstream or airflow, indicated generally as  110 , entering the fluidic oscillator  102  will first contact a concave surface  112  of the obstacle  108 . After contacting the concave surface  112 , the airflow  110  is bent or diverted around convex surfaces  114 A-B and into one of the two pathways  106 A-B, for example pathway  106 A as shown in  FIG. 4 , thereby creating a pressure node at the opposing pathway (e.g., pathway  106 B). Collectively, the pathways  106 A-B and the obstacle  108  define an oscillation chamber  111  within the housing  104 . 
         [0048]    In this aspect, the pressure differential caused by the pressure node in pathway  106 B causes the airflow  110  to then bend or divert the airflow away from the pathway that it is currently flowing through and towards the pathway containing the pressure node (i.e., pathway  106 B). This pattern of the airflow  110  traversing one pathway while generating a pressure node in the opposing pathway, until the pressure differential causes the airflow to switch pathways, occurs continuously while the airflow is entering the fluidic oscillator  102 . The frequency with which the airflow  110  alternates or oscillated between pathways  106 A-B has a linear relationship to the flow rate of air in the spirometer  102 . 
         [0049]    As shown, the pathways  106 A-B merge into a single outlet  116 . The outlet  116  may have any cross-sectional configuration. The outlet  116  is defined by the housing  104 . In particular, the outlet  116  is defined by sidewalls  118 A-B along with a top wall  118 C and a bottom wall  118 D. 
         [0050]    In one embodiment, at least the distal portions  120  of the sidewalls  118 A-B of the outlet chamber are angled linearly outward away from a central longitudinal axis  122  of the spirometer, thereby defining a greater volume for the airflow  110  to flow out of the fluidic oscillation chamber  111 , thereby reducing the airway resistance within the chamber. 
         [0051]    The spirometer  100  also includes a mouthpiece  130  engaged to the housing  104  for directing the airflow  110  to the oscillation chamber  111  of the fluidic oscillator  102 . In one aspect, the mouthpiece  130  is configured to engage an inlet  124  of the fluidic oscillator  102  that is defined by the housing  104 . The mouthpiece  130  may be integrated with the spirometer, such that the spirometer may have a solid unitary construction. 
         [0052]    In various embodiments, the mouthpiece  130  is detachable from the fluidic oscillator  102 . The mouthpiece  130  may be engaged to the fluidic oscillator  102  by a snap-fit engagement, a friction-fit engagement, or any other attachment mechanism. In one particular example, the mouthpiece is threaded and engaged to a corresponding threaded portion of the fluidic oscillator  102 . In another embodiment, the mouthpiece  130  is engaged to the oscillator  102  by aligning a projection on the mouthpiece  130  with a corresponding channel on the fluidic oscillator  102 . After alignment and insertion, the mouthpiece  130  may be rotated to securely attach the mouthpiece to the oscillator  102 . 
         [0053]    In one aspect, the mouthpiece  130  may be any solid conduit, including existing spirometer mouthpieces and filters, having a diameter greater than the diameter of the inlet  124  to reduce back pressure within the inlet and the oscillation chamber  111 . In this embodiment, the mouthpiece  130  may be a hollow cylinder having a uniform radius along its longitudinal length. In another embodiment, the mouthpiece  130  includes a nozzle  132 , as shown in  FIGS. 7-11  that is dimensioned to fit within the inlet  124  to form an airtight engagement. As seen in  FIG. 4 , the nozzle  132  directs a portion of the total airflow  134  generated by a user of the spirometer into the fluidic oscillator. 
         [0054]    In this embodiment, the mouthpiece  130  includes one or more baffles  136 A-B, to divert a portion of the total airflow  134  such that less than the total airflow in the mouthpiece enters the fluidic oscillator. For example, the airflow  110  that enters the fluidic oscillator  102  may be approximately 50% or less of the total airflow  134 . In another example, the airflow  110  that enters the fluidic oscillator  102  may be approximately 30% or less of the total airflow  134 . 
         [0055]    The baffles  136 A-B further define an inlet channel  138  and at least one vent channel. In the embodiment shown in  FIGS. 2, 4, 5, and 7-12 , the mouthpiece  130  includes two vent channels  140 A-B. In other embodiments, the mouthpiece may contain a single vent channel or alternately, may contain three or more vent channels. As shown, the vent channels divert portions of the total airflow  134  away from the fluidic oscillator and vents them to the environment, as indicated by  142 . 
         [0056]    In one embodiment, the vent channels  140 A-B may have generally circular cross-sections while the inlet channel  138  has a generally rectangular cross section. In another embodiment as shown, in  FIGS. 2, 7, 8, 10, and 12 , the inlet channel  138  and the vent channels  140 A-B may all have generally rectangular cross-sections. In all embodiments, the mouthpiece  130  is configured to decrease backpressure within the spirometer  100  such that the spirometer operates within guidelines established by the American Thoracic Society Standardization of Spirometry.  FIGS. 13-15  depict other embodiments of the mouthpiece  130 . As shown in  FIGS. 13 and 14 , the vent channels  140 A-B may have generally hemispherical cross-sections while the inlet channel  138  has a generally rectangular cross section. In various embodiments, the inlet channel  138  and the vent channels  140 A-B have cross-sections symmetrically normal to the direction of the total airflow  134 . In addition, the baffles  136  A-B and channels  138 ,  140 A, and  140 B can generate laminar flow for the turbulent airflow  134  that enters the spirometer. 
         [0057]      FIGS. 16-17  depict other embodiments of the spirometer  100  having an integrated inlet  131  thereby forming a single unitary construct. In these embodiments, some of the structure and features of the mouthpiece  130  may be integrated into the housing  102 . As such, the inlet includes baffles and channels similar to those previously described. 
         [0058]    The sensor  150  may be any sensor suitable for detecting the oscillations of the airflow  110  within the oscillation chamber  111  and generating an electronic signal related to detected oscillations. In various embodiments, the sensor may be a pressure transducer, a piezoelectric sensor, an acoustic sensor, or a thermal sensor, among others. In various embodiments, the sensor is placed along or near an axis of symmetry for the concave surface  112 . When the pressure node in the oscillation chamber exerts a large enough force on the jet of airflow  110  in one of the pathways  106 A-B and causes it to bend to the other side, the airflow  110  crosses the path of the sensor. In one embodiment, two measured passes of the airflow  110  across the sensor represents one period. 
         [0059]    In one embodiment, as shown in  FIGS. 3, 21, and 22 , the sensor  150  is an acoustic sensor, including but not limited to a microphone. The microphone is positioned proximate to the concave surface  112  of the obstacle  108  to detect and capture the acoustic signal or sound generated by the oscillations of the airflow  110  within the oscillation chamber  111 . As described further below, the signal generated by the microphone in response to the captured oscillations may be transmitted to or otherwise received at a computing device, including but not limited to a mobile computing device such as a smartphone, for example. 
         [0060]    In one aspect, the sensor  150  may be placed outside of the oscillation chamber. For example, the sensor  150  may be positioned over an opening  152  in the housing  104  that is proximate to the obstacle  108 . In another example, the opening  152  may be directly above an area proximate to the concave surface  112 . In this example, the sensor is engaged to the housing  104  in an air-tight engagement, such that the airflow  110  does not escape though the opening  152 . In yet another aspect, the sensor  150  may be inserted into airflow  110  through the opening  152 . In another example, the sensor may be placed flush with the concave surface  112  so that the airflow is normal to the sensor  150 . 
         [0061]    In another embodiment, the spirometer  100  may include multiple sensors  150 . For example, one or more sensors  150  may be placed within or proximate to each of the pathways  106 A-B. The placement of at least one sensor  150  in the pathways may further increase the accuracy of the data obtained by the sensor(s). In another example, a sensor  150  may be placed along the axis of symmetry for the concave obstacle surface  112  while another sensor is positioned within one of the pathways  106 A or  106 B. In this example, the ratio between the frequencies detected by the sensor near the obstacle  108  and the sensor in the pathway would be 2:1. As such sensor along the axis of symmetry would measure two passes of the airflow as a single period, while the sensor along the side channel or pathway would measure one pass as a single period. The combined recorded signals from both sensors would therefore continuously capture both the first and second harmonics of the data signal. In one aspect, the data signals generated by the multiple sensors may provide for greater accuracy during signal processing. For example, a comparison may be made between the two separate frequency curves that are traced out over time as the user exhales. The multiple sensors ultimately yield multiple curves for a single spirometry test. The multiple curves are evaluated and then compared or averaged together, in one embodiment, to create a more accurate result. 
         [0062]    As shown in  FIGS. 19-21 , the sensor  150  may be detachable from the housing of the spirometer  100 . In one aspect, the sensor may be housed in a modular sensor housing  154  that is configured to engage the housing  104  of the fluidic oscillator  102 . The modular sensor allows for a variety of sensors to be used with the spirometer. For example, the spirometer  100  may include a plurality of sensors  150  that each have their own modular sensor housing  154  and may be interchangeable to capture different characteristics of the airflow  110 . In various embodiments, the modular sensor housing may contain multiple sensors, for embodiments of the spirometer that include two or more sensors. Similarly, multiple modular sensor housings, each containing one or more sensor  105 , may be used with each spirometer device.  FIGS. 18A-C  are top views of other embodiments of the spirometer  100 . As shown the modular sensor housing  154  may have various shapes and configurations. 
         [0063]    The use of a detachable sensor(s)  150  also permits the user to clean or replace the sensor, if necessary. In various embodiments, the sensors and/or the modular sensor housing  154  include one or more membranes positioned over the sensor to protect it from wear and contaminants during exhalation or normal use. In one aspect, the membrane is configured to reduce undesired noise in the recorded signal. 
         [0064]    The sensor  150  is configured to transmit an electronic data signal to a computing device. For example, an acoustic sensor, such as a microphone, may include a wire or cable  156  that may be engaged to a computing device to permit communication between the sensor and the computing device. In one aspect, the cable  156  may be received in an audio jack, a USB port, a mini USB port, a micro USB port, or other ports of the computing device, including any proprietary connectors, such as those for Apple® devices. In another example, the sensor may transmit an electromagnetic wave data signal wirelessly to the computing device. 
         [0065]    In another embodiment, the computing device may further transmit the data signal to another device over a communication network  408 , including the Internet, cellular networks, and/or wireless networks, among others. For example, when a user exhales into the spirometer, an acoustic sensor  150  records the sounds produced by the oscillations. The sensor is also in communication with the computing device via the cable  156 . The computing device may store the data locally or further transmit the data via a cellular phone network or other communications network  408 , including but not limited to the Internet or other wireless and wired networks to a remote server or website for data analysis. In one example, the remote server or website may be accessible by the patient&#39;s healthcare provider, including but to limited to physicians, nurses, and other medical personnel, as well as insurance providers and carriers. The data may also be stored at the remote location and the analysis of the data may be transmitted or sent back to the computing device upon user access to the device or access via the cellular phone network or the communication network. 
         [0066]      FIGS. 23-25  depict embodiments of bi-directional spirometers  200  and  300 . The bi-directional spirometers  200  and  300  are similar to the spirometer  100  and may use the same mouthpiece  130  and sensor(s)  150 ; however, the bidirectional spirometers have one or more oscillation chambers  111  such that data can be recorded for airflow  110  traveling both away from (exhalation) and towards (inhalation) the user. The analysis of data for both exhalation and inhalation allows the spirometers  200  and  300  to acquire more quantitative values that characterize lung function. 
         [0067]    In one embodiment, shown in  FIG. 23 , the spirometer  200  has a bi-directional fluidic oscillator  202  defined, at least in part, by a housing  204  to provide two or more pathways  206 A-B for air traveling through the oscillator. The pathways  206 A-B are separated by a single obstacle  208 . In one embodiment, as shown in  FIGS. 4 and 5 , the obstacle  208  has a generally hourglass or bowtie shape. In this embodiment, airflow, indicated generally as  210 , entering the fluidic oscillator  202  will first contact a first concave surface  212 A of the obstacle  208 . After contacting the first concave surface  212 A, the airflow  210  is bent or diverted around a first pair of convex surfaces  214 A-B and into one of the two pathways  206 A-B, for example pathway  206 A, thereby creating a pressure node at the opposing other pathway (e.g., pathway  206 B). Collectively, the pathways  206 A-B and the obstacle  208  define two oscillation chambers  211 A-B arranged in series within the housing  204 . 
         [0068]    In this aspect, the pressure differential caused by the pressure node in pathway  206 B causes the airflow  210  to then bend or divert the airflow from the pathway that it is currently flowing through towards the pathway containing the pressure node (i.e., pathway  206 B). This pattern of the airflow  210  traversing one pathway while generated a pressure node in the opposing pathway, until the pressure differential causes the airflow to switch pathways occurs continuously, while the airflow is entering the fluidic oscillator  202 . The frequency with which the airflow  210  alternates or oscillates between pathways  206 A-B has a linear relationship to the flow rate of air in the spirometer  202 . 
         [0069]    In one aspect, a portion of the airflow  210  that enters each pathway  206 A-B bends around a second set of convex surfaces  214 C-D and contacts a second concave surface  212 B, where a second set of oscillations similar to those occurring at the first concave surface  212 A. 
         [0070]    In this embodiment, the pathways  206 A-B merge into a single outlet  216 . The outlet  216  may have any cross-sectional configuration. The outlet  216  is defined by the housing  204 . In particular, the outlet  216  is defined by sidewalls  218 A-B along with a top wall (not shown) and a bottom wall  218 C. 
         [0071]    In one embodiment, at least the distal portions  220  of the sidewalls  218 A-B of the outlet chamber are angled linearly outward away from a central longitudinal axis  222  of the spirometer, thereby defining a greater volume for the airflow  210  to flow out of the fluidic oscillation chamber  211 , thereby reducing the airway resistance within the chamber. 
         [0072]    The bi-directional spirometer  200  includes one or more sensors, similar to the sensor  150  that may be positioned proximate to concave surfaces  212 A-B, as indicated by  230 A-B. Each sensor  150  may be placed external to the oscillation chamber  211  or may be inserted into the airstream or airflow  210  at positions  230 A-B. In other embodiments, additional sensors may also be used to gather data from the airflow in one or more of the pathways  206 A-B. In yet another embodiment, the one or more sensors  150  may configured to record data from multiple inputs. For example, a microphone sensor may be configured to records acoustic signals at multiple locations simultaneously, similar to the multi-channel signals used in audio/visual equipment. 
         [0073]    Each oscillator chamber  211 A-B may be associated with a single shared sensor  150  or alternately, each may be associated with their own sensor  150 . The sensors for each oscillator chamber  211 A-B may be the same type of sensor, including but not limited to acoustic sensors, thermal sensors, and pressure transducers, among others. Conversely, each oscillator chamber  211 A-B may use different types of sensors to collect data. 
         [0074]    The bi-directional spirometer  300  has shown in  FIGS. 24-25 , includes two or more unidirectional fluidic oscillators  302 A-B, similar to the fluidic oscillator  102  that is arranged in parallel. In particular, the fluidic oscillators  302 A-B are arranged in a stacked configuration, where the fluidic oscillator  302 A is configured for oscillation during exhalation (air flowing in a forward direction) and lies on top of the fluidic oscillator  302 B that is configured for oscillation during inhalation (air flowing in a reverse direction). For example, a user may exhale through the spirometer  300  to generate airflow oscillations in the first fluidic oscillator  302 A, and inhale to generate oscillations in the second fluidic oscillator  302 B. In this embodiment, the outlet  316  for the spirometer  300  functions as an inlet during inhalation. 
         [0075]    In various other embodiments, the spirometer may include multiple bi-directional spirometers, such as the bi-directional spirometer  200 , in a stacked arrangement similar to the bi-directional spirometer  300 . Other arrangements, configurations, and sizes of unidirectional and bidirectional spirometers may be used. 
         [0076]    In this embodiment, each oscillator  302 A-B may be associated with a shared sensor  150  or alternately each may be associated with their own sensor  150 . The sensors for each fluidic oscillator  302 A-B may be the same type of sensor, including but not limited to acoustic sensors, thermal sensors, and pressure transducers, among others. Conversely, the spirometer  300  may include different types of sensors for each fluidic oscillator  302 A-B. Similar to the other embodiments of the spirometer  100  and  200 , the spirometer  300  may include additional sensors, positioned in one or more of the pathways  316 A-D for the fluidic oscillators  302 A-B. 
         [0077]      FIG. 26  is a block diagram of one embodiment of a system  400  and computing environment for collecting and analyzing spirometric data using a spirometer  100  and computing device  402  executing a spirometry application  416 . In various aspects, data collected using the spirometer  100  is transmitted to the computing device where the spirometry application is used to perform signal processing and data analysis. Although the system  400  is shown and described as using the spirometer  100 , the other embodiments of the spirometer  200 - 300  may also be used. 
         [0078]    In various embodiments, the spirometer  100  may include one or more additional sensors or monitors, indicated as  450  to gather additional data. These additional sensors  450  may be integrated with the spirometer  100  or may be in communication with the spirometer  100  or computing device  402 . For example, the additional sensor  450  may be an external air-monitoring device that measures air quality, allergens, temperature, and/or other environmental data. In another example, an additional sensor  450  is an inhaler monitoring device. For example, the spirometer  100  can communicate with a device that tracks medication usage (e.g., the GeckoCap or the Asthmapolis system), which are electronic devices engaged to an inhaler that record each time the inhaler is used and the location of usage. 
         [0079]    In yet another example, the additional sensor  450  may be an activity sensor. In this example, the spirometer  100  communicates with activity based sensors, such as but not limited to sensors that collect data from shoes, a watch or wristband, such as the Nike Fuelband™, a FitBit™, Misfit™ Basis™ or other sensors. In this example, the spirometer system  400  can be used to better understand how factors, such as activity level and heart rate, among others, affect or are affected by respiratory function. In another example, the additional sensor  450  may also be a pulse oximeter. 
         [0080]    The computing device  402  includes one or more processors or processing systems  404  and volatile and/or non-volatile memory  406  and is configured to receive data and/or communications from, and/or transmit data and/or communications to other computing devices (not shown) via a communication network  408 . Examples of a computing device  402  include smartphones, tablet computers, desktop computers, servers, and other computing devices. The computing device  402  communicates via wireless and/or wireline communication. 
         [0081]    The computing device  402  communicates with and stores data on a data storage device  409 . In one embodiment, the data storage device is a remote external storage device, such that the computing device  402  may retrieve and store data via the communication network  408  in a cloud computing environment. In another embodiment, the data storage device  409  may be incorporated with the computing device  402  or at least communicate directly with the computing device, as indicated by  411 . 
         [0082]    The computing device  402  also includes a display  410 , such as a computer monitor or screen, for displaying data and/or graphical user interfaces. The computing device  402  may also include an input device  412 , such as a keyboard or a pointing device (e.g., a mouse, trackball, pen, or touch screen) to enter data into or interact with graphical user interfaces. The computing device  402  also includes a computer readable medium (“CRM”)  414  configured with a spirometry application  416 . 
         [0083]    According to one aspect, the CRM  414  may include volatile media, nonvolatile media, removable media, non-removable media, and/or another available medium that can be accessed by the computing device  400 . By way of example and not limitation, the CRM  414  comprises computer storage media and communication media. Computer storage media includes nontransient memory, volatile media, nonvolatile media, removable media, and/or non-removable media implemented in a method or technology for storage of information, such as computer readable instructions, data structures, program modules, or other data. Communication media may embody computer readable instructions, data structures, program modules, or other data and include an information delivery media or system. 
         [0084]    The spirometry application  416  includes instructions or modules that are executable by the processing system  404  to receive and analyze data collected from the spirometer  100  that relates to various characteristics of the airflow  110  within the fluidic oscillator  102  and provides information and guidance to the user. For example, the application  416  may use data collected from each spirometric maneuver in the fluidic oscillator (spirometric data) and environmental data relevant to the user&#39;s location to warn the user of potential adverse environmental conditions that may affect the user&#39;s respiratory function. As described more fully below, the spirometry application  416  may perform a Fourier transform on the data signal to produce a spectrum relative to the spirometric maneuver(s). In addition, for each spectrum, the frequency of maximum intensity may be located and recorded. Each frequency of maximum intensity may be derived from an average of the specific oscillation frequencies for that set time interval. These frequencies are then converted to flow rates using a process of Linear Flow Rate Calibration. Each newly converted flow rate is then plotted at its corresponding time interval to create Flow Rate vs. Time plot(s). From these plots, spirometric data, including but not limited to forced vital capacity (FVC), volume that has been exhaled at the end of the first second of forced expiration (FEV 1 ), peak expiratory flow (PEF), and many other spirometry values can be calculated by calibrating the data and integrating the plot with respect to time. 
         [0085]    In one embodiment, the spirometry application  416  includes a user-interface (UI) module  418 , a data input module  420 , a Fourier transform module  422 , and a data output module  424 . In addition, the spirometry application  416  includes a sampling module  426 , a segmentation module  428 , a calibration module  430 , and an optimization module  432 . 
         [0086]    In other embodiments, the spirometry application  416  may include additional modules. In all embodiments, the functionality of each module may be shared and performed by one or more other modules. In addition, in at least one embodiment, the modules or, at least the functionality of each module, may be distributed across one or more computing devices in communication via the communication network  408 . 
         [0087]    The UI module  418  generates one or more user interfaces, including input forms for display at display  412 . For example, a user of the spirometry system  400  uses the input device  412  to interact with, for example, the spirometry application  416  or a web browser, via a user interface to access, interact and display data or other interfaces generated by the spirometry application. Example user interfaces  1000 A-C are depicted in  FIGS. 32-34 . 
         [0088]    The data input module  420  receives data from the spirometer and the user. The data received includes spirometry data, such as but not limited to the data signal, including audio signals that relates to an airflow vs. time curve, all relevant spirometry values, such as FVC, FEV 1 , and PEF. 
         [0089]    The data input module  420  also receives metadata for each spirometry test, user symptoms, medication usage, or other input data. In one aspect, the metadata includes geo-location data, such as the date, time, and location of the user during the spirometer test. The location may be obtained from GPS data of the computing device or derived from the communications network of the computing device. The metadata also includes environmental data, including but not limited to the temperature, barometric pressure, humidity, air quality index, local allergen and pollutant data (e.g. pollen counts, mold counts, etc.). 
         [0090]    Fourier transform module  422  performs Fourier transforms on the data signal. This module may perform any Fourier transform or wavelet transform, including but not limited to a short-time Fourier transform (STFT), to analyze the frequency spectrum at set time intervals. 
         [0091]    The data output module  424  generates data that may be displayed in one or more user interfaces or data forms. In one aspect, the data output module provides health assessment or risk assessment level interface to the user. In one aspect, the health or risk level of a user may be determined by comparing results from one or more spirometry tests to predicted test results. In this aspect, deviation from the predicted results may cause a change in the health or risk level assessment. The health or risk level assessment includes aggregated symptom data along with spirometry results, location and environmental data, weather data, and other relevant data. In one embodiment, the health or risk level assessment is provided on a continuous spectrum having a range from 0% to 100%, where a greater percentage is indicative of increase risk. The health assessment also presents the user with actionable items, such as how often to perform a spirometry test that day, as well as when to take a test based at least in part on the user&#39;s health or risk assessment level. As the risk level changes based on the timing of the test, in various embodiments, more recent tests or symptom would be weighted more heavily in computing the current health or risk assessment level. The test results would then decrease in value over time, as new data is added. 
         [0092]    The data output module  424  also allows users to store data in a cloud network. For example, the user can create a credential-based account to access their data via mobile devices or online via a web application or mobile applications (apps). In one aspect, caregivers and healthcare providers can connect with patient accounts to access patient data and monitor numerous patients. In addition, the data output module is configured to integrate with various electronic medical records systems. 
         [0093]    In another aspect, the data output module may generate alerts to caregivers and healthcare providers (via email, mobile application alerts, text message, etc.) when needed. These alerts may be generated, for example, after a symptom or attack, after an abnormal spirometry result, if a patient has not taken medicine in a predetermined number of days or other set time period, or after an elevated or adverse health or risk assessment level is reached (e.g., ≧50% risk of an adverse respiratory event, such as an asthma attack, among others). Other criteria may also be used to generate an alert. 
         [0094]    The data output module may also communicate and integrate with a user&#39;s asthma action plan, which tells users what actions to take based upon PEF, FEV1, or risk assessment level results. In addition, the data output may forecast future risk levels for future days based upon forecasted environmental data or weather conditions. The output module  424  also generates one or more user interface displays with the results of the forecast as well as the factors that are the most relevant for each day or forecasted time period. The forecast time periods may be in a range between hours and months. 
         [0095]    The sampling module  426  samples the data signal and in one embodiment, reduces the sampling rate of a signal by down sampling. The segmentation module  428  divides the data signal into discrete segments to identify portions of each spirometric maneuver such as the starting or initial points and the end points. In addition, the segmentation module  428  may also recombine segments of the data signal at any point during signal processing to further optimize the processed signal. 
         [0096]    The calibration module  430  executes one or more calibrations equations and algorithms to calibrate the spirometer device  100  and the data signal received therefrom. Similarly, the optimization module  432  executes one or more equations and algorithms to optimize the functionality and results of the other modules  418 - 430  and modules  434 - 444 , as described below with reference to  FIG. 31 . 
         [0097]    After a user performs a spirometric maneuver with the spirometer  100 , the data gathered by the sensor  150  is transferred for analysis external to the spirometer. In preferred embodiments, the analysis of the data signal occurs external to the fluidic oscillator  102 . As such, any circuitry or other electronic elements, including the sensor  150  in some embodiments, are external to the fluidic oscillator, thereby allowing for easy cleaning of the spirometer  100 . However, in at least one embodiment, the spirometer may be a standalone device having integrated a microprocessor and memory to record, process, and store the data. This embodiment may also be configured to communicate with an external device. 
         [0098]    In various embodiments, the data signal or the data within the data signal may be transmitted via text or media message, via a direct connection to a computing device, via phone call or via the Internet. The information may be analyzed at a local computing device, smartphone, a remote computing device, a web server, a website, or a voicemail service, such as Google voice. 
         [0099]    By way of example and not limitation, a data file transferred to a smartphone or cell telephone, may be sent through a cell phone or wireless communication network in the form of a text message to a website that analyzes the data and then sends the analysis back to the user over the cellular or wireless network. In another example, the data file may be sent through cell phone communication in the form of a phone call to a website that stores the message as an audio file. The audio file is then uploaded to a website that analyzes the data and sends the analysis back to the user over the phone. 
         [0100]    In yet another example, the data signal may be captured directly by one or more applications, such as the spirometry application  414 , previously described with reference to  FIGS. 26 and 31 , executing on the smartphone, tablet, or cell phone. In this example, the analysis is performed on the smartphone and displayed to the user. In a similar example, the data signal is captured directly at a desktop or laptop computing device that stores the data and analyzes the data via a program or application, such as the spirometer application, executing on the computing device. In addition, the local computing device may transmit the data to a remote computing device, such as a server for analysis. 
         [0101]      FIGS. 27-29  are block diagrams depicting various methods  500 - 800  for processing and analyzing the data signal received from the sensor  150  of the spirometer. In one aspect, the method may be performed on the spirometric data using the spirometry application  416 . 
         [0102]    In one embodiment, after a user of the spirometer  100  exhales or inhales through the device and the sensor  150  records the sound generated by the oscillation of air passing through the device, a data signal, which may be an audio signal in one embodiment, containing data related to the oscillations of air is received at the computing device  402 , at block  502 . At block  504 , the audio signal is down sampled or decimated at the sampling module  426  of the spirometry application  41 . In one aspect, the decimation of the signal prevents aliasing at the Nyquist&#39;s frequency. At block  506 , the peaks of the data signal are identified through iterative estimation at the segmentation module  428 , and at block  508 , the segmentation module identifies the starting and ending points for each spirometry maneuver in the signal. 
         [0103]    At block  510 , the Fourier transform module  422  performs multiple Short-Time Fourier Transforms (STFT) with varying window sizes on the data signal, in one embodiment. In other embodiments, the Fourier transform module  422  may perform a wavelet transform instead of or in addition to the STFT. After transformation, the maximum frequency within the spirometric maneuver is identified. Signal characteristics, such as the derivative of the data signal, the signal to noise ratio, and the signal power or intensity are then determined and used along with the maximum frequency to define a number of threshold or breaking points where the data signal will be segmented by the segmentation module  428 . As determined by the characteristics present in each segment, the segments will be drawn using the optimal STFT to increase accuracy of the data. For example, as the window size of the STFT changes the temporal or frequency resolution, it is desirable to identify the best window size(s) to optimize both the temporal and frequency resolution for each specific section of the frequency vs. time curve. The optimal STFT window size is determined by the slope of the curve (i.e. the frequency range present in a section divided by the change in time in a section). Therefore, it is ultimately the slope of the curve that determines the most appropriate STFT window size. 
         [0104]    At block  512 , a calibration equation relating the frequency to the flow rate for the optimized STFT is executed at the calibration module  430 . The optimization module  432  determines the volume of the airflow  110  by integrating the flow rates at block  516 . 
         [0105]    In various embodiments, the spirometry application  416  is also configured to reduce the noise within the data signal. For example, the spirometry application  416  may be used to perform a method  600  for reducing both the static noise and the dynamic noise within the data signal, as shown in  FIG. 28 . At block  602 , the spirometry application  416  employs adaptive noise cancellation after an initial analysis of the specific characteristics of the data signal. Based on those characteristics, the application  416  chooses the most appropriate methods of noise cancellation to use on the signal. For example, this may be based on the amount of static or dynamic noise present in each segment of the data signal. In addition, noise present in the signal could also be evaluated or quantified based on the measured or extrapolated flow characteristics (e.g., laminar or turbulent flow) of the air passing through the spirometer device. 
         [0106]    For example, to reduce static noise, the sampling module  426  performs differential noise cancellation by sampling the noise between each spirometric maneuver or before and after a single maneuver at block  604 . At block  606 , the sampling module  426  then removes the noise from portions of the signal for which this type of noise effects the quality of the data, namely where the signal to noise ratio is small (e.g., ≦2:1 (signal:noise)). Similarly, to reduce dynamic noise, the sampling module estimates the strength of the signal at block  608 . In one aspect, where the data signal is an audio signal, the data signal received from the sensor  150  is known to be continuous during each spirometric maneuver; therefore, the sampling module estimates the signal value rather than estimating the noise, as done in traditional approaches to noise reduction for audio signals. At block  610 , the appropriate noise cancelling process or algorithm for each segment is applied to remove dynamic noise from the data signal. 
         [0107]    Similarly, the application  416  may perform an adaptive flow rate determination process. For example, after analyzing specific characteristics of the data signal, the application  416  chooses the most appropriate method(s) to compute flow rates for each part of the signal based on the characteristics of the data signal. For example, the flow rate may be determined using calibration curves including a frequency vs. flow rate curve or an amplitude vs. flow rate curve. 
         [0108]      FIG. 29  is a flow diagram of another method  800  for processing and analyzing an audio data signal received from an acoustic sensor  150 . The method may be performed using the various modules  418 - 432  of the spirometry application  416 . The audio signal is received at the computing device  402  at block  802 . At block  804 , the audio signal is decimated to prevent aliasing based on Nyquist&#39;s frequency, while at block  806  the peaks of the audio signal are found. The start point and the end point of each spirometry maneuver in the audio signal is identified at block  808  and several STFTs with varying parameters are performed on the full signal at block  810 . 
         [0109]    Noise reduction is performed on each segment at block  812  by applying a bandpass filter to the STFT of the data signal, as the upper and lower boundary for the frequency range is known. As the data signal is a continuous signal, the boundaries for each segment are identified by breaking points based on the peak flow rate within the data signal. At block  816 , a calibration equation relating frequency to flow rate is applied to the STFT of the data signal. The locations of the peak flow rates are determined at block  818  and the flow rate is integrated to determine the volume of air passing through the spirometer at block  820 . 
         [0110]    At block  822 , the STFT is optimized. In one aspect, this includes segmenting or dividing the spirometric maneuver into four sections based on the ratio of each frequency to the maximum frequency within that maneuver. The STFT parameters are then specified for each section of the curve based on the frequencies present in each specific section to increase accuracy. Noise reduction is applied to each STFT section depending on the characteristics of that section. For example, the need for noise reduction is determined by the noise present, the signal-to-noise ratio, and the sections location in the maneuver cycle. The noise reduction may be performed using various techniques, including but not limited to the use of high pass filters and low pass filters, differential noise cancellation, using moving averages and any other filtering techniques. An optimized and continuous STFT is produced by piecing together the sections and their related STFT based on the intervals determined from the segmentation of the curve. 
         [0111]      FIG. 30  depicts a method  900  for calibrating the linear flow rate of the spirometer  100 ,  200 , or  300 , to determine the relationship between the oscillation frequency and the flow rate. At block  902 , an airstream is generated by a compressor, passed through a regulator and a variable area flow meter, and finally through the spirometer. In one aspect, the regulator is used to set a specific flow rate, which is then recorded using the flow meter. At block  904 , the sensor  150  on the spirometer records the sound of the oscillations, and the recorded data file undergoes the same or similar method, previously described with reference to  FIG. 27  at block  906 . The average frequency of maximum intensity is recorded at block  908 . As the incoming flow rate is known and constant, the frequency of maximum intensity can be directly related to the known flow rate. At block  910 , the frequency of maximum intensity is recorded and plotted against the flow rate for various flow rates and a trend line is then fit to the data points at block  912  to establish a linear equation that is largely independent of environmental factors, such as humidity, elevation, and pressure, can determine the flow rate for any given frequency. 
         [0112]    As shown in  FIG. 31 , another embodiment of the spirometer application  416 , as encoded on a CRM  414 , may include additional modules for performing additional functions in addition to analyzing the spirometric data. The application  416  may also include a medication module  434 , a symptoms module  436 , a coaching module  438 , a third-party resource module  440 , a quality control module  442 , and a rehabilitation/athletic training module  444 . 
         [0113]    The medication module  434  allows the user to establish a schedule for taking medications including identifying what medication is to be added, the dosage, frequency, and other relevant information. In one aspect, the medication module  434  alerts patients to take medication through text messages, emails, social media messages, as well as mobile phone alerts/notifications or app alerts/notifications. In addition, the medication module  434  includes “snooze” functionality where a user can postpone or delay their medication alert if they are unable to take their medication at that time. For example, the application  416  can be configured to remind the user again with another alert in a set period of time (e.g. 15 min, 30 min, 60 min, etc.). 
         [0114]    The medication module  434  also generates one or more user interfaces to accept input by the user to confirm that the medication was taken. The medication module  434  will then log this event as well as any relevant time/location/environmental data. In another aspect, the medication module  434  can recommend or determine an adjustment for the dosage of the medication within a set range based on symptoms, spirometry results, or other relevant criteria. Additionally, in another aspect, a caregiver or healthcare providers can remotely review or set medication information or alerts for a user at any time. 
         [0115]    The symptoms module  436  prompts the user to log any respiratory related symptoms within the application or on external media. For example, the symptoms module  436  may generate a user interface to log symptoms at a variable period before or after a spirometry test. The period may be, for example, every 3 hours, just before or after a spirometry test, or just before or after taking a medication. Other periods may also be used. 
         [0116]    The coaching module  438  provides real-time guidance and coaching to the user during the spirometry maneuvers and test. For example, the coaching module  438  uses pre-recorded encouragements or sound/musical encouragements. In a particular example, the coaching module  438  plays an ascending major scale as the user blows through the device, where each note of the scale is reached as the patient gets closer to maximal effort. In another example, the coaching module  438  provides visual encouragement, including the use of games to induce maximal effort from the user. In another aspect, the coaching module  438  provides post-test coaching and informs the user what actions to take after the test. For example, the coaching module  438  may identify shortcomings in the most recent test to prompt a better result the next time through audio and visual reminders or encouragement. 
         [0117]    In another aspect, the coaching module  438  also incorporates educational resources to help patients better understand their respiratory condition, for example asthma, and help them understand what they can do to better manage the condition. For example, the coaching module  438  includes an educational resource database where users can learn about their disease including how to take medication, how to do spirometry, and how to identify their disease triggers, among other data. 
         [0118]    The third-party resource module  440  allows researchers to interact with and customize the portions of the spirometry application  416  to design and implement studies or protocols. The researchers may push messages or forms to specific users or groups of users and track data from multiple groups to perform analysis by comparing users across and within various groups. 
         [0119]    The quality control module  442  identifies the errors in a spirometry test. For example, the quality control module  442  determines whether the test needs to be conducted again and informs the user of what changes are necessary to collect usable data. In one aspect, the module uses an algorithm to compare the test to previous approved tests or set ranges for various spirometric values. 
         [0120]    The rehabilitation/athletic training module  444  is useful to athletes or users undergoing rehabilitation to assess athletic performance and/or lung function. In one aspect, the training module  444  detects how the user is breathing to determine if the user is using the full capacity of their lungs when breathing or a specific percentage. In addition, the training module  444  measures the user&#39;s breathing recovery time after physical exertion via various spirometry tests. In another aspect, the module includes games or coaching for users during breathing exercises or spirometry tests. 
         [0121]    The description above includes example systems, methods, techniques, instruction sequences, and/or computer program products that embody techniques of the present disclosure. However, it is understood that the described disclosure may be practiced without these specific details. In the present disclosure, the methods disclosed may be implemented as sets of instructions or software readable by a device. Further, it is understood that the specific order or hierarchy of steps in the methods disclosed are instances of example approaches. Based upon design preferences, it is understood that the specific order or hierarchy of steps in the method can be rearranged while remaining within the disclosed subject matter. The accompanying method claims present elements of the various steps in a sample order, and are not necessarily meant to be limited to the specific order or hierarchy presented. 
         [0122]    Portions of the described disclosure may be provided as a computer program product, or software, that may include a machine-readable medium having stored thereon instructions, which may be used to program a computer system (or other electronic devices) to perform a process according to the present disclosure. A machine-readable medium includes any mechanism for storing information in a form (e.g., software, processing application) readable by a machine (e.g., a computer). The machine-readable medium may include, but is not limited to, magnetic storage medium (e.g., floppy diskette), optical storage medium (e.g., CD-ROM); magneto-optical storage medium; read only memory (ROM); random access memory (RAM); erasable programmable memory (e.g., EPROM and EEPROM); flash memory; or other types of medium suitable for storing electronic instructions. 
         [0123]    It is believed that the present disclosure and many of its attendant advantages will be understood by the foregoing description, and it will be apparent that various changes may be made in the form, construction, and arrangement of the components without departing from the disclosed subject matter or without sacrificing all of its material advantages. The form described is merely explanatory, and it is the intention of the following claims to encompass and include such changes. 
         [0124]    While the present disclosure has been described with reference to various embodiments, it will be understood that these embodiments are illustrative and that the scope of the disclosure is not limited to them. Many variations, modifications, additions, and improvements are possible. More generally, embodiments in accordance with the present disclosure have been described in the context of particular implementations. Functionality may be separated or combined in blocks differently in various embodiments of the disclosure or described with different terminology.