Dataset Information

Reference ranges for spirometry across all ages: a new approach.

ABSTRACT: The Third National Health and Nutrition Examination Survey (NHANES III) reference is currently recommended for interpreting spirometry results, but it is limited by the lack of subjects younger than 8 years and does not continuously model spirometry across all ages.By collating pediatric data from other large-population surveys, we have investigated ways of developing reference ranges that more accurately describe the relationship between spirometric lung function and height and age within the pediatric age range, and allow a seamless transition to adulthood.Data were obtained from four surveys and included 3,598 subjects aged 4-80 years. The original analyses were sex specific and limited to non-Hispanic white subjects. An extension of the LMS (lambda, mu, sigma) method, widely used to construct growth reference charts, was applied.The extended models have four important advantages over the original NHANES III analysis as follows: (1) they extend the reference data down to 4 years of age, (2) they incorporate the relationship between height and age in a way that is biologically plausible, (3) they provide smoothly changing curves to describe the transition between childhood and adulthood, and (4) they highlight the fact that the range of normal values is highly dependent on age.The modeling technique provides an elegant solution to a complex and longstanding problem. Furthermore, it provides a biologically plausible and statistically robust means of developing continuous reference ranges from early childhood to old age. These dynamic models provide a platform from which future studies can be developed to continue to improve the accuracy of reference data for pulmonary function tests.

SUBMITTER: Stanojevic S

PROVIDER: S-EPMC2643211 | biostudies-other | 2008 Feb

REPOSITORIES: biostudies-other

ACCESS DATA

Similar Datasets

Project description:Presepsin (soluble CD14 subtype) has been shown to be beneficial as a sepsis marker in adults. Nevertheless, very few data are available in neonates. The aim of the present study was to determine reference ranges of presepsin in term and preterm neonates.Healthy term neonates and preterm neonates without clinical signs of infection admitted to the Neonatal Unit were consecutively enrolled. Presepsin concentrations in whole blood were measured using a point-of-care assay system located in the Unit. Demographic data, antenatal and perinatal variables commonly affecting C-reactive protein and procalcitonin values were considered.Of the 684 neonates enrolled in the study, 484 (70.8%) were born at term and 200 (29.2%) were preterm (24-36 weeks' gestation). In term infants, presepsin median value was 603.5 pg/mL (interquartile range: 466.5-791 pg/mL; 5th and 95th centiles: 315 and 1178 pg/mL respectively). In preterm infants, presepsin median value was slightly higher, equal to 620 pg/mL (interquartile range: 503-864 pg/mL; 5th and 95th centiles: 352 and 1370 pg/mL respectively). The reference ranges of presepsin we determined were much higher than those seen in healthy adults. No correlation between presepsin levels and postnatal age was observed, as well as no significant difference was demonstrated in preterm neonates at different gestational ages. None of the variables analyzed affected presepsin levels at a clinical significant extent.For the first time, this study provides reference ranges of presepsin in term and preterm neonates. Having reliable reference values is crucial for obtaining an adequate diagnostic accuracy. Based on our results, most variables commonly affecting C-reactive protein and procalcitonin values do not affect presepsin levels, which suggests that presepsin could be an effective sepsis marker. Further investigations in large groups of neonates with sepsis are needed to determine the diagnostic and prognostic value of this biomarker.

Project description:Background:Use of different spirometry reference equations can lead to misinterpretation of spirometry results. Currently, no study has been carried out to determine if there is any discordance between the interpretation of spirometry data using the Global Lungs Initiative (GLI) 2012, the Third National Health and Nutrition Examination Survey (NHANES III), the Knudson, and the Siriraj reference equations in Thai people. Therefore, this study aimed to determine differences and agreements regarding spirometry results using the GLI2012, NHANES III, Knudson, and Siriraj reference equations in a Thai population. Methods:A retrospective study was carried out using 2,492 spirometry results from Thai people (age ranged 8-80 years old) who were referred by their physicians for spirometry testing at the Lung Health Center, Maharaj Nakorn Chiang Mai Hospital, Chiang Mai, Thailand between January 2005 and December 2015. The spirometry results were interpreted using four reference equations. Respiratory function patterns were classified as normal, spirometric restriction, obstruction, or mixed defect. The severity of abnormal patterns were classified as mild, moderate, moderately severe, severe or very severe. A Nominal Analysis of Variance (NANOVA) test was used to analyze differences in diagnosis and classification for the degree of severity. The Kappa statistic was used to determine agreements of spirometry results between four reference equations. Results:The differentiation in both spirometry diagnosis and the severity classification were significant across the four reference equations (P<0.001). However, the levels of agreement among the four reference equations were moderate to good (Kappa values ranged from 0.56 to 0.77 for the diagnosis and 0.67 to 0.82 for the severity). Conclusions:The results of this study suggest that the use of the GLI2012, NHANES III, Knudson, and Siriraj reference equations alters the interpretation of spirometry data in this population of Thai adults.

Dataset Information

Reference ranges for spirometry across all ages: a new approach.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets