Interpretative strategies for lung function tests
Riccardo Pellegrino,Giovanni Viegi,Vito Brusasco,Robert O. Crapo,Felip Burgos,Richard Casaburi,Allan L. Coates,C.P.M. van der Grinten,P. Gustafsson,John L. Hankinson,R. Jensen,D.C. Johnson,Neil R. MacIntyre,Roy T. McKay,Martin R. Miller,Daniel Navajas,O. F. Pedersen,J. Wanger +17 more
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This section is written to provide guidance in interpreting pulmonary function tests (PFTs) to medical directors of hospital-based laboratories that perform PFTs, and physicians who are responsible for interpreting the results of PFTS most commonly ordered for clinical purposes.Abstract:
SERIES “ATS/ERS TASK FORCE: STANDARDISATION OF LUNG FUNCTION TESTING”
Edited by V. Brusasco, R. Crapo and G. Viegi
Number 5 in this Series
This section is written to provide guidance in interpreting pulmonary function tests (PFTs) to medical directors of hospital-based laboratories that perform PFTs, and physicians who are responsible for interpreting the results of PFTs most commonly ordered for clinical purposes. Specifically, this section addresses the interpretation of spirometry, bronchodilator response, carbon monoxide diffusing capacity ( D L,CO) and lung volumes.
The sources of variation in lung function testing and technical aspects of spirometry, lung volume measurements and D L,CO measurement have been considered in other documents published in this series of Task Force reports 1–4 and in the American Thoracic Society (ATS) interpretative strategies document 5.
An interpretation begins with a review and comment on test quality. Tests that are less than optimal may still contain useful information, but interpreters should identify the problems and the direction and magnitude of the potential errors. Omitting the quality review and relying only on numerical results for clinical decision making is a common mistake, which is more easily made by those who are dependent upon computer interpretations.
Once quality has been assured, the next steps involve a series of comparisons 6 that include comparisons of test results with reference values based on healthy subjects 5, comparisons with known disease or abnormal physiological patterns ( i.e. obstruction and restriction), and comparisons with self, a rather formal term for evaluating change in an individual patient. A final step in the lung function report is to answer the clinical question that prompted the test.
Poor choices made during these preparatory steps increase the risk of misclassification, i.e. a falsely negative or falsely positive interpretation for a lung function abnormality or a change …read more
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Vital capacity and COPD: the Swedish CArdioPulmonary bioImage Study (SCAPIS)
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TL;DR: The prevalence of COPD was significantly higher when the ratio FEV1/VC was calculated using the highest value of SVC or FVC compared with using FVC only, and the use of only FVC when assessing airflow limitation may result in a considerable under diagnosis of subjects with mild COPD.
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Variability of the Prevalence of Undiagnosed Airflow Obstruction in Smokers Using Different Diagnostic Criteria
Arthur Chun-Wing Lau,Mary S.M. Ip,Christopher Kei Wai Lai,Kahlin Choo,Kam-shing Tang,Loretta Yin-Chun Yam,Moira Chan-Yeung +6 more
TL;DR: Undiagnosed AFO was prevalent in Hong Kong smokers and Estimated prevalence rates were highly affected by the criteria used to define AFO, so the predicted lower fifth percentile values calculated from a local reference equation as the LLN of FEV(1)/FVC ratio should be used for the diagnosis.
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Differentiating vocal cord dysfunction from asthma.
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Analysis of the MILES cohort reveals determinants of disease progression and treatment response in lymphangioleiomyomatosis.
Nishant Gupta,Hye-Seung Lee,Lisa R. Young,C Strange,Joel Moss,Lianne G. Singer,Koh Nakata,Alan F. Barker,Jeffrey T. Chapman,Mark L. Brantly,James M. Stocks,Kevin K. Brown,Lynch Jp rd,Hilary J. Goldberg,Gregory P. Downey,Angelo M. Taveira-DaSilva,Jeffrey P. Krischer,K. Setchell,Bruce C. Trapnell,Bruce C. Trapnell,Yoshikazu Inoue,Francis X. McCormack +21 more
TL;DR: Treatment with sirolimus is beneficial regardless of menopausal status, race, bronchodilator responsiveness, baseline FEV1 or TSC association, and serum vascular endothelial growth factor-D levels are clinically useful variables that should be taken into consideration when making therapeutic decisions and designing clinical trials for patients with lymphangioleiomyomatosis.
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Standardisation of spirometry
Martin R. Miller,John L. Hankinson,Vito Brusasco,Felip Burgos,Richard Casaburi,Allan L. Coates,Robert O. Crapo,Paul L. Enright,C.P.M. van der Grinten,P. Gustafsson,R. Jensen,D.C. Johnson,Neil R. MacIntyre,Roy T. McKay,Daniel Navajas,O. F. Pedersen,Riccardo Pellegrino,Giovanni Viegi,J. Wanger +18 more
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