MULTI-ETHNIC REFERENCE VALUES FOR SPIROMETRY FOR THE 3–95 YEAR AGE RANGE: THE GLOBAL LUNG FUNCTION 2012 EQUATIONS
By P. Quanjer, S. Stanojevic, T. Cole, X. Baur, G. Hall, B. Culver, P. Enright, J. Hankinson, M. Ip, Jinping Zheng and 1 more. European Respiratory Journal, 2012
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The aim of the Task Force was to derive continuous prediction equations and their lower limits of normal for spirometric indices, which are applicable globally. Over 160,000 data points from 72 centres in 33 countries were shared with the European Respiratory Society Global Lung Function Initiative. Eliminating data that could not be used (mostly missing ethnic group, some outliers) left 97,759 records of healthy nonsmokers (55.3% females) aged 2.5–95 yrs. Lung function data were collated and prediction equations derived using the LMS method, which allows simultaneous modelling of the mean (mu), the coefficient of variation (sigma) and skewness (lambda) of a distribution family. After discarding 23,572 records, mostly because they could not be combined with other ethnic or geographic groups, reference equations were derived for healthy individuals aged 3–95 yrs for Caucasians (n=57,395), African–Americans (n=3,545), and North (n=4,992) and South East Asians (n=8,255). Forced expiratory value in 1 s (FEV1) and forced vital capacity (FVC) between ethnic groups differed proportionally from that in Caucasians, such that FEV1/FVC remained virtually independent of ethnic group. For individuals not represented by these four groups, or of mixed ethnic origins, a composite equation taken as the average of the above equations is provided to facilitate interpretation until a more appropriate solution is developed. Spirometric prediction equations for the 3–95-age range are now available that include appropriate age-dependent lower limits of normal. They can be applied globally to different ethnic groups. Additional data from the Indian subcontinent and Arabic, Polynesian and Latin American countries, as well as Africa will further improve these equations in the future.
Subfields: Physiology, Pulmonary and Respiratory Medicine, Sociology and Political Science
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Citations in the corpus
- ERS/ATS technical standard on interpretive strategies for routine lung function tests (2021, methodology): “Considerations for individuals in whom standing height cannot be measured are summarized in the technical standards for each PFT (6-8).”
- GAMLSS: A distributional regression approach (2018, methodology): “The Global Lung Function Initiative (GLFI), [http://www.lungfunction.org, Quanjer et al. (2012)] uses GAMLSS to provide a Address for correspondence: Mikis D. Stasinopoulos, School of Computing and Digital Media, London Metropolitan University, 166-220 Holloway Rd, London N7 8DB, United Kingdom.”
- Weakly Supervised Disentanglement by Pairwise Similarities (2019, background): “However, the disease severity is usually measured by combining two (Vestbo et al. 2013) or three (Quanjer et al. 2012) spirometric measures.”