Applicability of the Old European Respiratory Society/European Community for Steel and Coal citationsRaw Equations For Spirometry Interpretation in Tunisian Adult Population

##plugins.themes.academic_pro.article.sidebar##

Published Feb 12, 2015
Download
pdf
Vol. 92 No. 8 (2014): Issue Aug 2014

##plugins.themes.academic_pro.article.main##

Mohamed Nour El Attar
Khaoula Hadj Mabrouk
Ahmed Ben Abdelaziz
Mohamed Bousarssar
Khélifa Limam
Chiraz Maatoug
Hmida Bouslah
Ameur Charrada
Sonia Rouatbi
Helmi Ben Saad

Abstract

Background : Tunisian pulmonary functional laboratories accept the default settings for citationsRaw equations (European Respiratory Society/European Community for Steel and Coal (ERS/ECSC1983) offered by the manufacturer even though adult Tunisian citationsRaw equations (Tunisian1995) are available. Objective : To compare the spirometric profile of Tunisian subjects, according to the two citationsRaw equations.

Population and methods : Spirometric data were recorded from 1192 consecutive spirometry procedures in adults aged 18-60 years. citationsRaw values and lower limits of normality (LLN) were calculated using the two citationsRaw equations. Applied definitions: large airway obstructive ventilatory defect (LAOVD): ratio between the 1st second expiratory volume and forced vital capacity (FEV1/FVC) < LLN. Small AOVD (SAOVD): FEV1/FVC > LLN and FVC > LLN and maximal midexpiratory flow < LLN. Tendency through a restrictive ventilatory defect (TRVD): FEV1 and FVC < LLN. The spirometric profile, according the two citationsRaw equations, was determined.

Results : Using Tunisian1995 citationsRaw equations, 34%, 7%, 37% and 19% of spirometry records were interpreted as normal, and as having, LAOVD, SAOVD and TRVD, respectively. Using ERS/ECSC1983 citationsRaw equations, 85%, 3%, 9% and 2% of spirometry records were interpreted as normal, and as having, LAOVD, SAOVD and TRVD, respectively. Using the ERS/ECSC1983 citationsRaw equations, misclassification was worse for LAOVD, for SAOVD and for TRVD, respectively, 68%, 94% and 89%.

Conclusion : Our results showed that the use of the old Caucasian citationsRaw equations resulted in misinterpretation of spirometry data in a significant proportion of subjects. This could result in inappropriate diagnosis and/or management.

Keywords:

Lung, Spirometry, Reference Values, Tunisia, Caucasian Race,Ethnic Groups

##plugins.themes.academic_pro.article.details##

References

  1. Quanjer PH, Stanojevic S, Cole TJ, Baur X, Hall GL, Culver BH et al. ERS Global Lung Function Initiative. Multi-ethnic reference values for spirometry for the 3-95-yr age range: the global lung function 2012 equations. Eur Respir J 2012;40:1324-43.
  2. Miller MR, Hankinson J, Brusasco V, Burgos F, Casaburi R, Coates A et al. ATS/ERS task force. Standardisation of spirometry. Eur Respir J 2005;26:319-38.
  3. Tabka Z, Hassayoune H, Guenard H, Zebidi A, Commenges D, Essabah H et al. Spirometric reference values in a Tunisian population. Tunis Med 1995;73:125-31.
  4. No authors listed. Standardized lung function testing. Report working party. Bull Eur Physiopathol Respir 1983;19 Suppl 5:1-95.
  5. Ben Saad H, Tfifha M, Harrabi I, Tabka Z, Guenard H, Hayot M et al.Factors influencing pulmonary function in Tunisian women aged 45 years and more. Rev Mal Respir 2006;23:324-38.
  6. Ben Saad H, Rouatbi S, Raoudha S, Tabka Z, Laouani Kechrid C, Hassen G et al. Vital capacity and peak expiratory flow rates in a NorthAfrican population aged 60 years and over: influence of anthropometric data and parity. Rev Mal Respir 2003;20:521-30.
  7. Bougrida M, Bourahli MK, Aissaoui A, Rouatbi S, Mehdioui H, Ben Saad H. Spirometric reference values for children living in Constantine (Eastern region of Algeria). Tunis Med 2012;90:51-61.
  8. Bougrida M, Ben Saad H, Kheireddinne Bourahli M, Bougmiza I, Mehdioui H. Spirometric reference equations for Algerians aged 19 to 73 years. Rev Mal Respir 2008;25:577-90
  9. Pellegrino R, Viegi G, Brusasco V, Crapo RO, Burgos F, Casaburi R et al. I ATS/ERS task force. Interpretative strategies for lung function tests. Eur Respir J 2005;26:948-68
  10. Ben Saad H, Ben Attia Saafi R, Rouatbi S, Ben Mdella S, Garrouche A, Zbidi A et al. Which definition to use when defining airflow obstruction? Rev Mal Respir 2007;24:323-30.
  11. 1. Miller MR, Crapo R, Hankinson J, Brusasco V, Burgos F, Casaburi R et al. ATS/ERS task force. General considerations for lung function testing. Eur Respir J 2005;26:153-61.
  12. . Ben Saad H, Ben Attia Saafi R, Rouatbi S, Ben Mdella S, Garrouche A, Hadj Mtir A et al. Which definition to use when defining reversibility of airway obstruction? Rev Mal Respir 2007;24:1107-15.
  13. Ben Saad H, Préfaut C, Tabka Z, Zbidi A, Hayot M. The forgotten message from gold: FVC is a primary clinical outcome measure of bronchodilator reversibility in COPD. Pulm Pharmacol Ther 2008;21:767- 73.
  14. Donnelly PM, Yang TS, Peat JK, Woolcock AJ. What factors explain racial differences in lung volumes? Eur Respir J 1991;4:829-38.
  15. Trabelsi Y, Ben Saad H, Tabka Z, Gharbi N, Bouchez Buvry A, Richalet JP et al. Spirometric reference values in Tunisian children. Respiration 2004;71:511-8.
  16. Ben Saad H. The narghile and its effects on health. Part I: the narghile. General description and properties. Rev Pneumol Clin 2009;65:369-75
  17. Ben Saad H. The narghile and its effects on health. Part II: the effects of the narghile on health. Rev Pneumol Clin 2010;66:132-44.
  18. Tockman MS, Pearson JD, Fleg JL, Metter EJ, Kao SY, Rampal K et al. Rapid decline in FEV1. A new risk factor for coronary heart disease mortality. Am J Respir Crit Care Med 1995;151:390-8.
  19. Ben Saad H, Khemis M, Bougmiza I, Prefaut C, Aouina H, Mrizek N et al. Spirometric profile of narghile smokers. Rev Mal Respir 2011;28:e39-51.
  20. Quanjer PH, Hall GL, Stanojevic S, Cole TJ, Stocks J. Global Lungs Initiative. Age- and height-based prediction bias in spirometry reference equations. Eur Respir J 2012;40:190-7.
  21. National Institute of Statistics and Economic Studies. Guide to occupational categories. Paris: INSEE, 1993.
  22. World Health Organization. Obesity: preventing and managing the global epidemic. WHO; 1998. Report of a WHO Consultation on obesity. Geneva, 3-5 June 1997 (WHO/NUT/NCD/98.1).
  23. ATS statement-Snowbird workshop on standardization of spirometry. Am Rev Respir Dis 1979;119:831-8.
  24. Gardner RM, Hankinson JL. Standardization of spirometry-1987 ATS update (American thoracic society). J Occup Med 1988;30:272-3.
  25. Cotes JE, Chinn DJ, Quanjer PH, Roca J, Yernault JC. Standardization of the measurement of transfer factor (diffusing capacity). 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 1993;16:41-52.
  26. Respiratory Society of French Language (SPLF). Second French edition of the European Guidelines for pulmonary function. Rev Mal Respir 2001;18:6S13-52
  27. Quanjer PH, Tammeling GJ, Cotes JE, Pedersen OF, Peslin R, Yernault JC. 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 1993;6:5-40.
  28. Jenicek M, Cleroux R. Clinical epidemiology: its evolution and role in clinical practice and research. Union Med Can 1985;114:625-32
  29. Fleiss JL. The measurement and control of misclassification error. In: Fleiss JL. Editor. Statistical methods for rates and proportions. 2nd ed. New York: John Wiley;1973 p. 140-54;1981 p. 213.
  30. Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1986;1:307-10.
  31. Ganguli M, Lytle ME, Reynolds MD, Dodge HH. Random versus volunteer selection for a community based study. J Gerontol A Biol Sci Med Sci 1998;53:M39-46
  32. National Institute of Statistics. http://www.ins.nat.tn/indexfr.php (accessed the 8th of June 2013)
  33. Aggarwal AN, Gupta D, Behera D, Jindal SK. Applicability of commonly used Caucasian prediction equations for spirometry interpretation in India. Indian J Med Res 2005;122:153-64.
  34. Hankinson JL, Odencrantz JR, Fedan KB. Spirometric reference values from a sample of the general U.S. population. Am J Respir Crit Care Med 1999;159:179-87.
  35. Crapo RO, Morris AH, Gardner RM. Reference spirometric values using techniques and equipment that meet ATS recommendations. Am Rev Respir Dis 1981;123:659-64.
  36. Knudson RJ, Lebowitz MD, Holberg CJ, Burrows B. Changes in the normal maximal expiratory flow-volume curve with growth and aging. Am Rev Respir Dis 1983;127:725-34.
  37. Swanney MP, Jensen RL, Crichton DA, Beckert LE, Cardno LA, Crapo RO. FEV(6) is an acceptable surrogate for FVC in the spirometric diagnosis of airway obstruction and restriction. Am J Respir Crit Care Med 2000;162:917-9.
  38. No authors listed. Standardization of spirometry. 1994 Update. American Thoracic Society. Am J Respir Crit Care Med 1995;152:1107-36.
  39. Hall GL, Thompson BR, Stanojevic S, Abramson MJ, Beasley R, Coates A et al. The global lung initiative 2012 reference values reflect contemporary Australasian spirometry. Respirology 2012;17:1150-1.
  40. Crapo RO. Role of reference values in making medical decisions. Indian J Med Res 2005;112:100-2
  41. Aggarwal AN, Gupta D, Behera D, Jindal SK. Comparison of fixed percentage method and lower confidence limits for defining limits of normality for interpretation of spirometry. Respir Care 2006;51:737-43.
  42. Thompson BR, Stanojevic S, Abramson MJ, Beasley R, Coates A, Dent A et al. Reference Ranges Working Party. The all-age spirometry reference ranges reflect contemporary Australasian spirometry. Respirology 2011;16:912-7
  43. White NW. ‘Ethic discounting' and spirometry. Respir Med 1995;89:312- 3.
  44. Braun L, Wolfgang M, Dickersin K. Defining race/ethnicity and explaining difference in research studies on lung function. Eur Respir J 2013;41:1362-70
  45. Shaffer BA, Samet JM, Coultas DB, Stidley CA. Prediction of lung function inHispanics using local ethnic-specific and external non-ethnicspecific predictionequations. Am Rev Respir Dis 1993;147:1349-53.
  46. Gólczewski T. Spirometry: a comparison of prediction equations proposed by Lubin ski for the Polish population with those proposed by the ECSC/ERS and by Falaschetti et al. Pneumonol Alergol Pol 2012;80:29-40.