Abstract

Background and Aim: Chronic obstructive pulmonary disease (COPD) is highly prevalent, yet underdiagnosis and delayed identification remain significant challenges, particularly in underserved communities. N-Tidal Diagnose 1 (NTD) is a novel diagnostic device providing rapid point-of-care assessment for COPD, from 75 seconds of relaxed tidal breathing. We evaluated its feasibility and acceptability during a new community lung health event delivered by the Southampton Integrated Neighbourhood Hub.

Methods: In March and May 2026, NTD testing was offered to attendees with suspected COPD, and delivered by two respiratory clinicians who had received 20-30 minutes of online training beforehand. Individuals received a result within approximately five minutes, indicating the likelihood of COPD, and were advised to follow up with their GP for further testing where appropriate. A user feedback survey assessed the overall acceptability of the device.

Results: Thirty adults (18 female; age [mean, SD]: 74 ± 7 years) completed NTD testing, with 28 (93%) also completing feedback surveys. Eighteen (60%) were former smokers and three (10%) were current smokers, with a mean pack‑year history of 25 ± 18. Twenty-one (70%) were already receiving inhaled therapy, and at least 19 (68%) had previously undergone lung function testing. Notably, one individual with Bell’s palsy had previously been unable to successfully complete standard diagnostic testing; NTD therefore provided their first objective respiratory measurement. NTD testing was rated as “very easy” (68%), “easy” (29%), or “neither easy nor difficult” (4%) to perform. Instructions were rated as “very easy” (82%) or “easy” (18%) to follow. Comfort was rated as “very comfortable” (75%) or “comfortable” (25%). No concerns were reported before, during, or after testing, aside from one individual who reported pre‑existing symptoms that were unchanged. All individuals indicated willingness to use the device again and would recommend it to others.

Conclusions: NTD was acceptable for use in a community setting due to its ease of use, demonstrating the feasibility of its integration into a neighbourhood initiative to support early identification of COPD. Further evaluation in larger and more diverse cohorts, particularly individuals without prior lung function testing, is warranted to better define its role within community diagnostic pathways.