The Differences in Spirometry Predictive Equations in Classifying Presence and Degree of Lung Function Impairment: Which Suit Fits the Best?
- 132 Downloads
The aim of this study was to compare the differences between three most commonly used predictive equations (PE): ECCS (European Community of Coal and Steel), the third National Health and Nutrition Examination Survey (NHANES III), and GLI (Global Lung Initiative) in healthy individuals and when grading severity of lung function impairment in patients with obstructive lung diseases.
The study included 200 healthy volunteers and 200 patients with obstructive lung diseases at the Institute for Pulmonary Diseases of Vojvodina. In all subjects, we calculated the absolute and relative (percent) predicted values using ECCS, NHANES III, and GLI reference equations.
The mean differences between ECCS and NHANES III predicted values were 5.63% (95% CI 5.29–5.98%, p < 0.001) for FEV1 and 10% (95% CI 9.52–10.79%, p < 0.001) for FVC. Similar differences were observed between ECCS and GLI predicted values. There were minimal differences between NHANES III and GLI predictive values. In healthy subjects, the mean absolute difference between measured FEV1 and FEV1 ECCS predicted was 0.36l (95% CI 0.32l, 0.40l, p < 0.001), FEV1 NHANES predicted was 0.30 l (95% CI 0.27–0.35l, p < 0.001), and FEV1 GLI predicted was 0.31l (95% CI 0.27– 0.35l, p < 0.001). The use of three different PE leads to significant differences in classification of obstruction severity in both asthma and COPD patients.
There were significant differences between FEV1 and FVC predicted when using different PE. The absolute difference between actual and predicted FEV1 in healthy individuals was highest when using ECCS. The use of different PE may change the interpretation of severity of airway obstruction.
KeywordsSpirometry Lung function tests Asthma COPD
Compliance with Ethical Standards
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
- 1.From the Global strategy for the diagnosis, management and prevention of COPD, global initiative for chronic obstructive lung disease (GOLD) 2017. http://goldcopd.org
- 2.From the Global strategy for asthma management and prevention, Global Initiative for Asthma (GINA) 2017. http://ginasthma.org
- 6.Quanjer PH, Tammeling GJ, Cotes JE, Pedersen OF, Peslin R, Yernault JC (1993) Lung volumes and forced ventilatory flows. Report working party standardization of lung function tests, European Community for Steel and Coal. Official statement of the European Respiratory Society. Eur Respir J Suppl 16:5–40CrossRefPubMedGoogle Scholar
- 9.Goldman MD, Smith HJ, Ulmer WT (2005) Whole-body plethysmography. Eur Respir Monogr 31:15Google Scholar
- 11.Smith HJ, Reinhold P, Goldman MD (2005) Forced oscillation technique and impulse oscillometry. Eur Respir Monogr 31:72Google Scholar
- 13.Riffenburgh RH (2006) Statistics in medicine, 2nd edn. Elsevier Academic Press, WalthamGoogle Scholar
- 14.Altman DG (1991) Practical statistics for medical research. Chapman and Hall, LondonGoogle Scholar
- 15.Reference values for spirometry. http://www.spirxpert.com/gli_ref_values.html. Accessed 30 Mar 2017
- 18.Iglesias I, Benavides M, Delgado YP, Mir I, Rovira S, Torrent A et al (2014) Validation of the global lung function initiative (GLI) spirometry reference equations in school age Spanish children. Eur Respir J 44(Suppl 58):P4519Google Scholar