Choosing the Better Global Lung Initiative 2012 Equation in South African Population Groups.
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SUBMITTER: Smith SJ
PROVIDER: S-EPMC7737576 | biostudies-literature | 2020 Dec
REPOSITORIES: biostudies-literature
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Choosing the Better Global Lung Initiative 2012 Equation in South African Population Groups.
Smith Sara-Jane SJ Gray Diane M DM MacGinty Rae P RP Hall Graham L GL Stanojevic Sanja S Mphahlele Reratilwe R Masekela Refiloe R Masekela Refiloe R
American journal of respiratory and critical care medicine 20201201 12
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Project description:BACKGROUND:The validation of the multi-ethnic GLI-2012 spirometric norms has been debated in several countries. However, its applicability in Algeria has not been verified. AIM:To ascertain how well the GLI-2012 norms fit contemporary adult Algerian spirometric data. METHODS:This was a cross-sectional study of a convenience sample of 300 healthy non-smoker adults (50% men, age range: 18-85 years) recruited from the Algiers region general population. All participants underwent a clinical examination and a plethysmography measurement. Z-scores for some spirometric data [FEV1, FVC, FEV1/FVC and forced expiratory flow at 25-75% of FVC (FEF25-75%)] were calculated. If the average Z-score deviated by "< ± 0.5" from the overall mean, the GLI-2012 norms would be considered as reflective of contemporary Algerian spirometry. RESULTS:The means±SDs of age, height, weight, FVC, FEV1, FEV1/FVC and FEF25-75% of the participants were, respectively, 48±17 years, 1.65±0.10 m, 73±14 kg, 4.04±1.04 L, 3.18±0.82 L, 0.79±0.05 and 4.09±1.09 L/s. Almost the quarter of participants were obese. The total sample means±SDs Z-scores were 0.22±0.87 for FVC, 0.04±0.88 for FEV1, -0.34±0.67 for FEV1/FVC and 0.93±0.79 for FEF25-75%. For men and women, only the means±SDs of the FEF25-75% Z-scores exceeded the threshold of "± 0.5", respectively, 1.13±0.77 and 0.73±0.76. CONCLUSION:Results of the present study, performed in an Algerian population of healthy non-smoking adults, supported the applicability of the GLI-2012 norms to interpret FEV1, FVC and FEV1/FVC but not the FEF25-75%.
| S-EPMC6122801 | biostudies-literature
Project description:BackgroundSpirometry reference values specifically designed for Asian Americans are currently unavailable. The performance of Global Lung Function Initiative 2012 (GLI-2012) equations on assessing spirometry in Asian Americans has not been evaluated. This study aimed to assess the fitness of relevant GLI-2012 equations for spirometry in Asian Americans.MethodsAsian subjects who never smoked and had qualified spirometry data were extracted from the National Health and Nutrition Examination Survey (NHANES) 2011-2012. Z-scores of forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), and FEV1/FVC were separately constructed with GLI-2012 equations for North East (NE) Asians, South East (SE) Asians, and individuals of mixed ethnic origin (Mixed). In addition, Proportions of subjects with observed spirometry data below the lower limit of normal (LLN) were also evaluated on each GLI-2012 equation of interest.ResultsThis study included 567 subjects (250 men and 317 women) aged 6-79 years. Spirometry z-scores (z-FEV1, z-FVC, and z-FEV1/FVC) based on GLI-2012 Mixed equations had mean values close to zero (- 0.278 to - 0.057) and standard deviations close to one (1.001 to 1.128); additionally, 6.0% (95% confidence interval (CI) 3.1-8.9%) and 6.4% (95% CI 3.7-9.1%) of subjects were with observed data below LLN for FEV1/FVC in men and women, respectively. In contrast, for NE Asian equations, all mean values of z-FEV1 and z-FVC were smaller than - 0.5; for SE Asian equations, mean values of z-FEV1/FVC were significantly smaller than zero in men (- 0.333) and women (- 0.440).ConclusionsGLI-2012 equations for individuals of mixed ethnic origin adequately fitted spirometry data in this sample of Asian Americans. Future studies with larger sample sizes are needed to confirm these findings.
| S-EPMC5984415 | biostudies-literature
Project description:Background and objectivesLung function depends nonlinearly on age and height, so that the use of age and height specific reference values is required. The widely used age and height specific GLI (Global Lung Initiative) z-scores derived from cross-sectional data, however, have not been proven for validity in an elderly population or for longitudinal data. Therefore, we aimed to test their validity in a population of elderly women followed prospectively for more than 20 years.MethodsWe used spirometric data (forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC) and FEV1/FVC) from the SALIA cohort of German women (baseline: 1985-1994 (aged 55 years), follow-up: 2008/2009 and 2012/2013). We calculated GLI-z-scores for baseline and follow-up examination separately (cross-sectional evaluation) and individual differences in z-scores between baseline and follow-up (longitudinal evaluation) for healthy never-smoking women.ResultsGLI reference values for FEV1, FVC and FEV1/FVC were cross-sectionally and longitudinally equivalent with our SALIA data. The mean change in z-scores between baseline and follow-up was 0.33 for FEV1, 0.38 for FVC and -0.10 for FEV1/FVC.ConclusionsIn conclusion, GLI z-scores fit cross-sectionally and longitudinally with FEV1, FVC and FEV1/FVC measured in women from Germany which indicates that they can be used in longitudinal association analyses.
| S-EPMC4910985 | biostudies-literature
Project description:Background: The Global initiative for chronic Obstructive Lung Disease (GOLD) ABCD groupings were recently modified. The GOLD 2011 guidelines defined increased risk as forced expiratory volume in 1 second (FEV1) < 50% predicted or ≥ 2 outpatient or ≥ 1 hospitalized exacerbation in the prior year, whereas the GOLD 2017 guidelines use only exacerbation history. We compared mortality and exacerbation rates in the Genetic Epidemiology of COPD Study cohort (COPDGene®) by 2011 (exacerbation history/FEV1 and dyspnea) versus 2017 (exacerbations and dyspnea) classifications. Methods: Using data from COPDGene®, we tested associations of ABCD groups with all-cause mortality (Cox models, adjusted for age, sex, race and comorbidities) and longitudinal exacerbations (zero-inflated Poisson models). Results: In 4469 individuals (mean age 63.1 years, 44% female), individual distributions in 2011 versus 2017 systems were: A, 32.0% versus 37.0%; B, 17.6% versus 36.3%; C, 9.4% versus 4.4%; D, 41.0% versus 22.3%; (observed agreement 76% [expected 27.8%], Kappa 0.67, p<0.001). Individuals in group D-2011 had 1.1 ± 1.6 exacerbations/year (mean ± standard deviation [SD]) versus 1.4 ± 1.8 for D-2017 (median follow-up 3.7 years). Using group A as reference, for both systems, mortality (median follow-up 6.8 years) was highest in group D (D-2011, [hazard ratio] HR 5.2 [95% confidence interval (CI) 4.2, 6.4]; D-2017, HR 5.5 [4.5, 6.8]), lowest for group C (HR 1.9 [1.4, 2.6] versus HR 1.9 [1.3, 2.8]) and intermediate for group B (HR 2.6 [2.0, 3.4] versus HR 3.4 [2.8, 4.1]). GOLD 2011 had better mortality discrimination (area under the curve [AUC] 0.68) than GOLD 2017 (AUC 0.66, p<0.001 for comparison) but similar exacerbation rate prediction. Conclusions: Relative to the GOLD 2011 consensus statement, discriminate predictive power of the 2017 ABCD classification is similar for exacerbations but lower for survival.
| S-EPMC6373581 | biostudies-literature
Project description:Background and objectiveWe aimed to assess the validity of using the Global Lung Function Initiative's (GLI) 2012 equations to interpret lung function data in a healthy workforce of South Australian Metropolitan Fire Service (SAMFS) personnel.MethodsSpirometry data from 212 healthy, nonsmoking SAMFS firefighters were collected and predicted normal values were calculated using both the GLI and local population derived (Gore) equations for forced expiratory volume in one second (FEV1), forced vital capacity (FVC), and FEV1/FVC. Two-tailed paired sample Student's t-tests, Bland-Altman assessments of agreement, and z-scores were used to compare the two prediction methods.ResultsThe equations showed good agreement for mean predicted FEV1, FVC, and FEV1/FVC. Mean z-scores were similar for FEV1 and FVC, although not FEV1/FVC, but greater than 0.5. Differences between the calculated lower limits of normal (LLN) were significant (p < 0.01), clinically meaningful, and resulted in an 8% difference in classification of abnormality using the FEV1/FVC ratio.ConclusionsThe GLI equations predicted similar lung function as population-specific equations and resulted in a lower incidence of obstruction in this sample of healthy SAMFS firefighters. Further, interpretation of spirometry data as abnormal should be based on both an FEV1 and FEV1/FVC ratio < LLN.
| S-EPMC5463135 | biostudies-literature
Project description:Training in procedures has been identified as the top priority for core medical trainees (GMC trainee survey 2011). Current practice relies on each trainee being lucky enough to encounter each procedure during clinical rotations and during on-calls. Where trainees are not lucky enough, they are entering their registrar years without the skills to efficiently lead the medical 'on-take'.(1) This can lead to delays in patient diagnosis or treatment. Because a single delay can easily burgeon into a lengthy series of multiple delays, this can lead to an associated prolongation of patient stay.(3) Both confidence and competence in practical procedures can be increased with a procedure bleep system. A dedicated procedure bleep, carried on a rotational basis alerts the bleep holder when a medical procedure is planned. The bleep holder then attends to observe, assist, perform, or teach the relevant procedure. This scheme shares the opportunities for procedure exposure amongst all trainees and ensures that a good breadth of experience has been gained independent of current placement. Formal evaluation revealed that 95% (19/20) of junior trainees felt more confident and competent as a result of participation. Furthermore, consultants felt this initiative reduced the burden on the medical registrars on-call. By ensuring our diagnostic and therapeutic interventions are conducted efficiently, we are actively reducing length of hospital stay and improving the standard of healthcare provided.
| S-EPMC4663826 | biostudies-literature
Project description:The Wheat Initiative (WI) and the WI Expert Working Group (EWG) for Agronomy (www.wheatinitiative.org) were formed with a collective goal to "coordinate global wheat research efforts to increase wheat production, quality, and sustainability to advance food security and safety under changing climate conditions." The Agronomy EWG is responsive to the WI's research need, "A knowledge exchange strategy to ensure uptake of innovations on farm and to update scientists on changing field realities." The Agronomy EWG aims to consolidate global expertise for agronomy with a focus on wheat production systems. The overarching approach is to develop and adopt a systems-agronomy framework relevant to any wheat production system. It first establishes the scale of current yield gaps, identifies defensible benchmarks, and takes a holistic approach to understand and overcome exploitable yield gaps to complement genetic increases in potential yield. New opportunities to increase productivity will be sought by exploiting future Genotype × Environment × Management synergies in different wheat systems. To identify research gaps and opportunities for collaboration among different wheat producing regions, the EWG compiled a comprehensive database of currently funded wheat agronomy research (n = 782) in countries representing a large proportion of the wheat grown in the world. The yield gap analysis and research database positions the EWG to influence priorities for wheat agronomy research in member countries that would facilitate collaborations, minimize duplication, and maximize the global impact on wheat production systems. This paper outlines a vision for a global WI agronomic research strategy and discusses activities to date. The focus of the WI-EWG is to transform the agronomic research approach in wheat cropping systems, which will be applicable to other crop species.
| S-EPMC7308648 | biostudies-literature
Project description:BackgroundThe 2012 Global Lung Function Initiative (GLI2012) provide multi-ethnic spirometric reference equations (SRE) for the 3-95 year-old age range, but Sub-Saharan African populations are not represented. This study aimed to evaluate the fit of the African-American GLI2012 SRE to a population of healthy urban and peri-urban Zimbabwean school-going children (7-13 years).MethodsSpirometry and anthropometry were performed on black-Zimbabwean children recruited from three primary schools in urban and peri-urban Harare, with informed consent and assent. Individuals with a history or current symptoms of respiratory disease or with a body mass index-z score (BMI) < - 2 were excluded. Spirometry z-scores were generated from African-American GLI2012 SRE, which adjust for age, sex, ethnicity and height, after considering all GLI2012 modules. Anthropometry z-scores were generated using the British (1990) reference equations which adjust for age and sex. The African-American GLI2012 z-score distribution for the four spirometry measurements (FVC, FEV1, FEV1/FVC and MMEF) were evaluated across age, height, BMI and school (as a proxy for socioeconomic status) to assess for bias. Comparisons between the African-American GLI2012 SRE and Polgar equations (currently adopted in Zimbabwe) on the percent-predicted derived values were also performed.ResultsThe validation dataset contained acceptable spirometry data from 712 children (344 girls, mean age: 10.5 years (SD 1.81)). The spirometry z-scores were reasonably normally distributed, with all means lower than zero but within the range of ±0.5, indicating a good fit to the African-American GLI2012 SRE. The African-American GLI2012 SRE produced z-scores closest to a normal distribution. Z-scores of girls deviated more than boys. Weak correlations (Pearson's correlation coefficient < 0.2) were observed between spirometry and anthropometry z-scores, and scatterplots demonstrated no systematic bias associated with age, height, BMI or socioeconomic status. The African-American GLI2012 SRE provided a better fit for Zimbabwean paediatric spirometry data than Polgar equations.ConclusionThe use of African-American GLI2012 SRE in this population could help in the interpretation of pulmonary function tests.
| S-EPMC7048020 | biostudies-literature
Project description:BackgroundWe aimed to investigate the accuracy of different equations in evaluating estimated glomerular filtration rate (eGFR) in a Chinese population with different BMI levels.MethodsA total of 837 Chinese patients were enrolled, and the eGFRs were calculated by three Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations, three full-age spectrum (FAS) equations and two Modification of Diet in Renal Disease (MDRD) equations. Results of measured GFR (mGFR) by the 99Tcm-diathylenetriamine pentaacetic acid (99Tcm-DTPA) renal dynamic imaging method were the reference standards. According to BMI distribution, the patients were divided into three intervals: below 25th(BMIP25), 25th to 75th(BMIP25-75) and over 75th percentiles (BMIP75).ResultsThe medium BMI of the three BMI intervals were 20.9, 24.8 and 28.9 kg/m2, respectively. All deviations from mGFR (eGFR) were correlated with BMI (p < 0.05). The percentage of cases in which eGFR was within mGFR ±30% (P30) was used to represent the accuracy of each equation. Overall, eGFRFAS_Cr_CysC and eGFREPI_Cr_2009 performed similarly, showing the best agreement with mGFR among the eight equations in Bland-Altman analysis (biases: 4.1 and - 4.2 mL/min/1.73m2, respectively). In BMIP25 interval, eGFRFAS_Cr got - 0.7 of the biases with 74.2% of P30, the kappa value was 0.422 in classification of CKD stages and the AUC60 was 0.928 in predicting renal insufficiency, and eGFREPI_Cr_2009 got 2.3 of the biases with 71.8% of P30, the kappa value was 0.418 in classification of CKD stages and the AUC60 was 0.920 in predicting renal insufficiency. In BMIP25-75 interval, the bias of eGFRFAS_Cr_CysC was 4.0 with 85.0% of P30, the kappa value was 0.501 and the AUC60 was 0.941, and eGFRFAS_Cr_CysC showed balanced recognition ability of each stage of CKD (62.3, 63.7, 68.0, 71.4 and 83.3% respectively). In BMIP75 interval, the bias of eGFREPI_Cr_CysC_2012 was 3.8 with 78.9% of P30, the kappa value was 0.484 the AUC60 was 0.919, and eGFREPI_Cr_CysC_2012 equation showed balanced and accurate recognition ability of each stage (60.5, 60.0, 71.4, 57.1 and 100% respectively). In BMIP75 interval, the bias of eGFRFAS_Cr_CysC was - 1.8 with 78.5% of P30, the kappa value was 0.485, the AUC60 was 0.922. However, the recognition ability of each stage of eGFRFAS_Cr_CysC eq. (71.1, 61.2, 70.0, 42.9 and 50.0% respectively) was not as good as GFREPI_Cr_CysC_2012 equation.ConclusionFor a Chinese population, we tend to recommend choosing eGFRFAS_Cr and eGFREPI_Cr_2009 when BMI was around 20.9, eGFRFAS_Cr_CysC when BMI was near 24.8, and eGFREPI_Cr_CysC_2012 when BMI was about 28.9.
| S-EPMC8145837 | biostudies-literature
Project description:BackgroundMeasuring incidence is important for monitoring and maintaining the safety of the blood supply. Blood collected from repeat-donors has provided the opportunity to follow blood donors over time and has been used to estimate the incidence of viral infections. These incidence estimates have been extrapolated to first-time donors using the ratio of NAT yield cases in first-time versus repeat-donors. We describe a model to estimate incidence in first-time donors using the limiting antigen (LAg) avidity assay and compare its results with those from established models.MethodsHIV-positive first-time donations were tested for recency using the LAg assay. Three models were compared; incidence estimated for (1) first-time donors using LAg avidity, (2) first-time and repeat-donors separately using the NAT yield window period (WP) model and (3) repeat-donors using the incidence/WP model.ResultsHIV incidence in first-time donors was estimated at 3·32 (CI 3·11, 3·55) and 3·81 (CI 3·07, 4·73) per 1000 PY using the LAg assay and NAT yield WP models, respectively. Incidence in repeat-donors was between 2·0- and 2·5-fold lower than in first-time donors estimated at 1·56 (CI 1·37, 1·77) and 1·94 (CI 1·86-2·01) per 1000 PY using the NAT yield/WP and incidence/WP models, respectively.ConclusionTesting HIV-positive donations using the LAg assay provides a reliable method to estimate incidence in first-time donors for countries that collect the majority of blood from first-time donors and do not screen with NAT.
| S-EPMC7970713 | biostudies-literature