Guided release of a breath (GRAB)

Background and Aim: UBTs are normally performed in the hospital under the guidance of trained technicians. However, COVID-19 has reduced access to within-hospital UBTs. Self-conducted UBTs at home by patients have been suggested as an alternative. This study aims to compare the efficacy of written versus video instructions in performing unsupervised UBT well. Methods: In the first arm of this prospective study, 20 consecutive first-time UBT patients were randomized to receive either written or video instructions. Competency for self-conducted UBTs were determined by an observer assessing their technique for 5 key steps and scored upon 5. In the subsequent study, a second enhanced video was created learning from common pitfalls from the first study and tested on a separate group of 10 patients. Results: There was no difference in the completion rate at 30% but there was a lower mean score 2.3 versus 3.9 (p = 0.29) for written versus video group respectively. The most common errors found were mixing up the steps and no inflation of the bag, all of which were addressed in the enhanced video. The enhanced video group had a higher completion rate of 60%. There was a significant difference between enhanced video and written instruction (mean score of 4.6 versus 2.3;p = 0.04). Older participants and those less educated had a lower completion rate. Conclusion: Video instructions can enhance the successful collection of a breath during UBT and should therefore be considered for use to improve both completion and accuracy of self-conducted UBTs at home.