Defining ‘healthy’ in preschool‐aged children for forced oscillation technique reference equations

Shackleton, Claire; Czövek, Dorottya; Grimwood, Keith; Ware, Robert S.; Radics, Bence; Hantos, Zoltán; Sly, Peter D.

doi:10.1111/resp.13186

Cited by 13 publications

(28 citation statements)

References 40 publications

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“…[38][39][40] Given that we excluded any participant with chronic respiratory illnesses, hospitalizations for bronchiolitis or pneumonia and smoking history from our final data set, it is not surprising that our cohort of healthy young Indigenous Australians achieved spirometry values higher than those achieved in earlier studies. As seen in previous studies, 32,33 there was no significant difference in the mean z-score results when participants who were mildly symptomatic were excluded from the final cohort (mean z-score (SD) for FEV 1 : 0.03 (0.91) and 0.02 (0.93); FVC: 0.08 (0.98) and 0.17 (0.97); FEV 1 /FVC: −0.18 (0.91) and −0.37 (0.78) for males and females, respectively).…”

Section: Discussionsupporting

confidence: 81%

“…). In the interests of developing a more inclusive reference set, we did not exclude participants who reported mild, common cold‐like symptoms ( n = 90) at the time of testing or within the last 3 months …”

Section: Methodsmentioning

confidence: 99%

“…In the interests of developing a more inclusive reference set, we did not exclude participants who reported mild, common cold-like symptoms (n = 90) at the time of testing or within the last 3 months. 32,33 Data analysis was performed using the Global Lung Function Initiative 29 and Stata15 (StataCorp, College Station, TX, USA). One-way analysis of variance (ANOVA) was performed to examine differences in z-scores of all lung function values between the ethnic groups for males and females.…”

Section: Final Data Set Data Management and Statistical Analysismentioning

confidence: 99%

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Global Lung Function Initiative‐2012 ‘other/mixed’ spirometry reference equation provides the best overall fit for Australian Aboriginal and/or Torres Strait Islander children and young adults

et al. 2019

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Background and objective Ethnic‐specific reference equations are recommended when performing spirometry. In the absence of appropriate reference equations for Australian Aboriginal and/or Torres Strait Islanders (Indigenous), we determined whether any of the existing Global Lung Function Initiative (GLI)‐2012 equations were suitable for use in Indigenous children/young adults. Methods We performed spirometry on 1278 participants (3–25 years) who were identified as Aboriginal, Torres Strait Islander or ‘both’. Questionnaires and medical records were used to identify ‘healthy’ participants. GLI2012_DataConversion software was used to apply the ‘Caucasian’, ‘African‐American’ and ‘other/mixed’ equations. Results We included 930 healthy participants. Mean z‐scores for forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) were lower than the Caucasian predicted values (range: −0.53 to −0.60) and higher than African‐American (range: 0.70 to 0.78) but similar to other/mixed (range: 0.00 to 0.08). The distribution of healthy participants around the upper and lower limits of normal (~5%) fit well for the other/mixed equation compared to the Caucasian and African‐American equations. Conclusion Of the available GLI‐2012 reference equations, the other/mixed reference equation provides the best overall fit for Indigenous Australian children and young adults (3–25 years). Healthy data from additional communities and adults around Australia will be required to confirm generalizability of findings.

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Section: Discussionsupporting

confidence: 81%

Section: Methodsmentioning

confidence: 99%

Section: Final Data Set Data Management and Statistical Analysismentioning

confidence: 99%

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Global Lung Function Initiative‐2012 ‘other/mixed’ spirometry reference equation provides the best overall fit for Australian Aboriginal and/or Torres Strait Islander children and young adults

et al. 2019

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“…Whether the use of the RLC model facilitates the use of oscillometry remains to be seen. We have demonstrated the changes occurring in R and C in the first 3 days of life in healthy neonates [19], shown the ability of C to distinguish between infants born to mothers who smoked during pregnancy and those born to nonsmoking mothers [20] and provided normative data for preschool-aged children [21].…”

Section: Improved Understanding Of T-oscillometry Outcome Variablesmentioning

confidence: 97%

The International Collaboration to Improve Respiratory Health in Children (INCIRCLE) ERS Clinical Research Collaboration

Sly¹,

Hantos²

2018

Eur Respir J

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Respiratory disease is a major component of the global burden of disease, with a reduction in deaths from childhood pneumonia but an increase in chronic respiratory disease over the past few decades [1-3]. There is an increasing recognition that low lung function poses a major risk for acute and chronic lung disease. Lung function tracks closely along centiles throughout childhood [4, 5], with lung function at birth determining lung function in later life [6]. Childhood asthma is associated with low lung function [7, 8], with the deficit seen on the first occasion that it is measured. Low lung function in childhood, with failure to reach predicted peak lung function in early adult life, is a major risk factor for chronic obstructive pulmonary disease (COPD), responsible for about 50% of cases in adults [9, 10]. Airway obstruction, generally indicated by a ratio of the forced expiratory volume in 1 s (FEV1) to the forced vital capacity (FVC) of <0.7 following bronchodilator inhalation, is a hallmark of COPD [11]. Indeed, the reliance on forced spirometry (so named to indicate the forced expiration required) may be one of the reasons that the major impact of early-life factors on COPD has been under-recognised [6]. Forced spirometry can be challenging in young children [12], with reported success rates varying from 30% to >80% [12, 13]. Young children find several aspects of spirometry difficult, including: taking a full breath in to total lung capacity; achieving a rapid onset of forced expiration; blowing hard enough to achieve expiratory flow limitation; and maintaining forced expiration to residual volume [12]. Given these difficulties, it is easy to understand why FVC may be underestimated in young children. In addition, in healthy young children, FEV1 approximates FVC, with a FEV1/FVC ratio of about 94% in children aged 5-7 years [14]. Thus, the physiological meaning of FEV1 differs in young children. This, together with the

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“…In this issue of the Journal, Shackleton et al . present an elegant approach to exploring this issue and its impact on respiratory mechanics of young children.…”

mentioning

confidence: 99%

How ‘healthy’ do children really need to be? Going beyond the limits

Simpson

Hall

2017

Respirology

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Defining ‘healthy’ in preschool‐aged children for forced oscillation technique reference equations

Cited by 13 publications

References 40 publications

Global Lung Function Initiative‐2012 ‘other/mixed’ spirometry reference equation provides the best overall fit for Australian Aboriginal and/or Torres Strait Islander children and young adults

Global Lung Function Initiative‐2012 ‘other/mixed’ spirometry reference equation provides the best overall fit for Australian Aboriginal and/or Torres Strait Islander children and young adults

The International Collaboration to Improve Respiratory Health in Children (INCIRCLE) ERS Clinical Research Collaboration

How ‘healthy’ do children really need to be? Going beyond the limits

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