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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Parenchymal preserving anatomic resections result in less pulmonary function loss in patients with Stage I non-small cell lung cancer
Ryan A. Macke,Matthew J. Schuchert,David D. Odell,David O. Wilson,James D. Luketich,Rodney J. Landreneau +5 more
TL;DR: Parenchymal-sparing resections resulted in better preservation of pulmonary function at a median of one year, suggesting a long-term functional benefit with small anatomic segmental resections (1–2 segments).
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COPD in Helsinki, Finland: socioeconomic status based on occupation has an important impact on prevalence
TL;DR: Although smoking is the main modifiable risk factor for COPD, the disease was significantly related to manual workers and non-manual assistant employees, i.e. socioeconomic groups reflecting occupation.
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Incorporating Lung Diffusing Capacity for Carbon Monoxide in Clinical Decision Making in Chest Medicine.
TL;DR: A clinically friendly approach for Dlco interpretation that takes caveats into consideration is outlined and the clinical scenarios in which Dl co can effectively assist the chest physician are discussed and illustrated clinical cases are presented.
Journal ArticleDOI
Survey of clinical infant lung function testing practices.
Stacey L. Peterson-Carmichael,Margaret Rosenfeld,Simon B. Ascher,Christoph P. Hornik,H.G.M. Arets,Stephanie D. Davis,Graham L. Hall +6 more
TL;DR: Data supporting the clinical use of infant lung function (ILF) tests are limited making the interpretation of clinical ILF measures difficult.
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Respiratory Symptoms, Spirometric Respiratory Impairment, and Respiratory Disease in Middle-Aged and Older Persons
TL;DR: Whether a novel definition of spirometric respiratory impairment from the Global Lung Initiative (GLI) is strongly associated with respiratory symptoms and, in turn, frequently establishes symptomatic respiratory disease is evaluated.
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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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