The Differences in Spirometry Predictive Equations in Classifying Presence and Degree of Lung Function Impairment: Which Suit Fits the Best?

Vukoja, Marija; Bokan, Aleksandar; Vujasinovic, Gordana; Kopitović, Ivan

doi:10.1007/s00408-017-0065-7

Cited by 7 publications

(5 citation statements)

References 14 publications

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“…For the cases with normal FEV1 z-score, they were considered mild using FEV1%. These findings were on line with previous studies conducted by LINARES-PERDEMO et al, VUKOJA et al, and CHAIWONG et al, who have compared different reference equations used to define the LLN of FEV1 and FEV1/FVC ratio to define an OVI and grade its severity [17][18][19] and concluded that significant differences existed when classifying degree of lung function impairment with different predictive equations in patients with obstructive lung diseases [20]. The meaning of a low FEV1/FVC ratio with a normal FEV1 is unclear.…”

Section: Discussionsupporting

confidence: 91%

Defining and Grading an Obstructive Ventilatory Impairment: American Thoracic Society/ European Respiratory Society Interpretive Strategies of 2005 Versus 2022

Barkous,

Kchaou,

Briki

et al. 2024

AJMAH

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Background: The American Thoracic Society (ATS) and the European Respiratory Society (ERS) have issued several updates to their guidelines for lung function testing between 2005 and 2022. Objective: We aimed to compare ATS/ERS recommendations for 2005(R1) and 2022(R2) in defining Obstructive Ventilatory Impairment (OVI) and in classifying its severity. Patients and Methods: It was a retrospective comparative study including 1129 patients. All patients underwent spirometry with measurement of Forced Expiratory Volume in 1 second (FEV1) and Forced Vital Capacity (FVC). An OVI was considered according to R1 when FEV1/FVC ratio is under the Lower Limit of Normal (LLN) and when the z-score of FEV1/FVC ratio is under -1.645 according to R2. For the severity levels of airflow obstruction: ATS/ERS previously recommended the use of percent predicted FEV1 with 5 levels using cut values of 70%, 60%, 50% and 35%. Recently updated for z-scores with cut values of -2, -2.5 and -4. Mean age was 54.23±19.23 years. Results: For defining an OVI, both definitions were comparable (529 patients with OVI). For the severity classification, the following proportions were assessed: 151 mild, 86 moderate,84 moderately severe, 133 severe and 75 very severe vs 148 mild, 238 moderate, 76 severe and 67 cases having a normal FEV1 (z-score of FEV1 above -1.645), which were classified as mild according to R1. Mild OVI(R2) were distributed according to R1 into 74 mild, 51 moderate, 16 moderately severe and 7 severe. Moderate OVI (R2) were dispatched using R1 to 10 mild, 34 moderate, 66 moderately severe, 103 severe and 25 very severe. Severe OVI(R2) were classified as 1 moderate, 2 moderately severe, 23 severe and 50 very severe. Conclusion: ATS/ERS new and previous recommendations seem to be comparable in defining OVI. However, discrepancies were assessed in classifying its severity.

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Section: Discussionsupporting

confidence: 91%

Defining and Grading an Obstructive Ventilatory Impairment: American Thoracic Society/ European Respiratory Society Interpretive Strategies of 2005 Versus 2022

Barkous,

Kchaou,

Briki

et al. 2024

AJMAH

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“…Therefore, the rates of the severity classification of AO changed when changing from the Siriraj to the GLI2012 reference equation, in particular in the case of a mild degree of impairment. Our results were similar to a previous finding suggesting that the rates of severity classification of AO (COPD and asthma) were changed when changing from the ECSC to the GLI2012 reference equations [13]. However, two other studies showed a concordance of severity classification between the NHANES III and the GLI2012 reference equations [10,16].…”

Section: Discussionsupporting

confidence: 89%

“…The GLI 2012 has also been recommended for use in every country, including Thailand. Previous studies have shown a concordance in the diagnosis associated with AO when using the GLI2012 and the Third National Health and Nutrition Examination Survey (NHANES III) [10,11,12,13], the European Community for Steel and Coal (ECSC) [11], and the Zapletal [14]. However, there is some discordance in the interpretation of AO when changing from the ECSC [10,14,15], and the Stanojevic [10] to the GLI2012.…”

Section: Introductionmentioning

confidence: 99%

Effect of the Application of the Global Lung Initiative 2012 Spirometry Reference Equation on the Diagnosing and Classifying Degree of Airway Obstruction in Thai Adults Aged 40 to 80 Years Old

et al. 2019

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Background and objective: Changing to a different spirometry reference equation can result in misinterpretation of spirometric findings. Currently, there is limited data about any discordance between the interpretations of airway obstruction (AO) using the Global Lungs Initiative (GLI) 2012 and the currently employed Thai reference equations (Siriraj) in Thai adults. Therefore, this study aimed to determine differences in diagnosis around AO and classification of the severity of AO using the GLI2012 and Siriraj reference equations in Thai adults. Materials and Methods: We analyzed spirometric results from Thai adults aged 40–80 years old (n = 2084), which were collected at the Lung Health Center, Maharaj Nakorn Chiang Mai Hospital, Chiang Mai, Thailand between January 2005 and December 2015. The diagnoses concerning the AO were interpreted using the GLI2012 and Siriraj reference equations. The severity of AO in each case was classified into five grades, including mild, moderate, moderately severe, severe, or very severe. McNemar’s test was used to analyze differences in diagnosis of AO and classification of the level of severity. The Kappa statistic was used to determine agreements of diagnosis of AO and classification of severity between the two reference equations. Results: There were significant differences in both diagnosis of AO and their classifying severity level between the two reference equations (p-value < 0.001). However, the levels of agreement between the two reference equations were moderate to very good in different age and sex groups (Kappa values ranged from 0.62 to 0.78 for the diagnosis of AO and 0.54 to 0.89 for the classification of severity). Conclusions: Changing from the Siriraj to the GLI2012 reference equations underestimates the proportion of airway obstruction in Thai adults.

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“…36 Forced vital capacity (FVC) and forced expiratory volume in the first second (FEV1) were recorded and the predicted FEV 1 and FVC were calculated as previously described. 37…”

Section: Spirometrymentioning

confidence: 99%

Metabolic Dysfunction-associated Fatty Liver Disease is Associated with Greater Impairment of Lung Function than Nonalcoholic Fatty Liver Disease

Miao¹,

Yang²,

Guo³

et al. 2022

J Clin Transl Hepatol

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Background and Aims:We compared lung function parameters in nonalcoholic fatty liver disease (NAFLD) and metabolic dysfunction-associated fatty liver disease (MAFLD), and examined the association between lung function parameters and fibrosis severity in MAFLD. Meth-ods: In this cross-sectional study, we randomly recruited 2,543 middle-aged individuals from 25 communities across four cities in China during 2016 and 2020. All participants received a health check-up including measurement of anthropometric parameters, biochemical variables, liver ultrasonography, and spirometry. The severity of liver disease was assessed by the fibrosis (FIB)-4 score. Results: The prevalence of MAFLD was 20.4% (n=519) and that of NAFLD was 18.4% (n=469). After adjusting for age, sex, adiposity measures, smoking status, and significant alcohol intake, subjects with MAFLD had a significantly lower predicted forced vital capacity (FVC, 88.27±17.60% vs. 90.82±16.85%, p<0.05) and lower 1 s forced expiratory volume (FEV 1 , 79.89±17.34 vs. 83.02±16.66%, p<0.05) than those with NAFLD. MAFLD with an increased FIB-4 score was significantly associated with decreased lung function. For each 1-point increase in FIB-4, FVC was diminished by 0.507 (95% CI: −0.840, −0.173, p=0.003), and FEV 1 was diminished by 0.439 (95% CI: −0.739, −0.140, p=0.004). The results remained unchanged when the statistical analyses was performed separately for men and women. Conclusions: MAFLD was significantly associated with a greater impairment of lung function parameters than NAFLD.

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The Differences in Spirometry Predictive Equations in Classifying Presence and Degree of Lung Function Impairment: Which Suit Fits the Best?

Abstract: 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.

Cited by 7 publications

References 14 publications

Defining and Grading an Obstructive Ventilatory Impairment: American Thoracic Society/ European Respiratory Society Interpretive Strategies of 2005 Versus 2022

Defining and Grading an Obstructive Ventilatory Impairment: American Thoracic Society/ European Respiratory Society Interpretive Strategies of 2005 Versus 2022

Effect of the Application of the Global Lung Initiative 2012 Spirometry Reference Equation on the Diagnosing and Classifying Degree of Airway Obstruction in Thai Adults Aged 40 to 80 Years Old

Metabolic Dysfunction-associated Fatty Liver Disease is Associated with Greater Impairment of Lung Function than Nonalcoholic Fatty Liver Disease

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