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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TLDR
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
Citations
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"GOLD or lower limit of normal definition? A comparison with expert-based diagnosis of chronic obstructive pulmonary disease in a prospective cohort-study".
Gülmisal Güder,Susanne Brenner,Christiane E. Angermann,Georg Ertl,Matthias Held,Alfred P E Sachs,Jan-Willem J. Lammers,Pieter Zanen,Arno W. Hoes,Stefan Störk,Frans H. Rutten +10 more
TL;DR: GOLD criteria over-diagnosed COPD, while LLN definitions under-diagnose COPD in elderly patients as compared to an expert panel diagnosis, and incorporation of FEV1 and RV/TLC into the GOLD-COPD or LLN-based definition brings both definitions closer to expert paneldiagnosis, and to daily clinical practice.
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BMI, leisure-time physical activity, and physical fitness in adults in China: results from a series of national surveys, 2000-14.
Ye Tian,Chongmin Jiang,Mei Wang,Rui Cai,Yanfeng Zhang,Zihong He,Huan Wang,Dongming Wu,Fubaihui Wang,Xin Liu,Zhongtao He,Ping An,Munan Wang,Qiang Tang,Yang Yang,Jin Zhao,Shaojun Lv,Weihai Zhou,Bo Yu,Jiang Lan,Xinping Yang,Linxia Zhang,Hui Tian,Zhuangzhuang Gu,Yiqing Song,Tianyi Huang,Tianyi Huang,Lars R. McNaughton +27 more
TL;DR: Wang et al. as discussed by the authors investigated these factors in Chinese adults over a 14-year period (2000-14) using data from randomised national surveys and found that the prevalence of obesity increased from 8·6% in 2000, to 10·3% in 2005, 12·2% in 2010, and 12·9% in 2014 (estimated increase 0·32% per year, 95% CI 0·30-0·33).
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The Clinical Importance of Dynamic Lung Hyperinflation in COPD
TL;DR: The basic pathophysiology of COPD during rest, exercise and exacerbation is discussed to better understand how this can be pharmacologically manipulated for the patient's benefit and current concepts of the mechanisms of symptom relief and improved exercise endurance following pharmacological lung volume reduction are reviewed.
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Pulmonary, Gonadal, and Central Nervous System Status after Bone Marrow Transplantation for Sickle Cell Disease
Mark C. Walters,Karen A. Hardy,Sandie Edwards,Thomas V. Adamkiewicz,James Barkovich,Françoise Bernaudin,George R. Buchanan,Nancy Bunin,Roswitha Dickerhoff,Roger Giller,Paul R. Haut,John T. Horan,Lewis L. Hsu,Naynesh Kamani,John E. Levine,David A. Margolis,Kwaku Ohene-Frempong,Melinda Patience,Rupa Redding-Lallinger,Irene Roberts,Zora R. Rogers,Jean E. Sanders,J. Paul Scott,Keith M. Sullivan +23 more
TL;DR: Individuals who had stable donor engraftment did not experience sickle-related complications after BMT, and were protected from progressive CNS and pulmonary disease, particularly among female recipients.
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Increased Airway Smooth Muscle Mass in Children with Asthma, Cystic Fibrosis, and Non-Cystic Fibrosis Bronchiectasis
Nicolas Regamey,Matthias Ochs,Tom Hilliard,Christian Mühlfeld,Nikki Cornish,Louise Fleming,Sejal Saglani,Eric W.F.W. Alton,Andrew Bush,Peter K. Jeffery,Jane C. Davies +10 more
TL;DR: Increase in ASM (both number and size) occur in children with chronic inflammatory lung diseases that include CF, asthma, and BX, but not to myocyte size.
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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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