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Effects of adopting the new global lung function initiative 2012 reference equations on the interpretation of spirometry

The aim of this study was to document the likely interpretative effects of changing from commonly used current spirometry reference equations to the GLI2012...

Authors:
Brazzale DJ, Hall GL, Pretto JJ

Authors notes:
Respiration. 2013;86(3):183-189

Keywords:
Obstruction, Respiratory function test, Restriction, Spirometry reference equations

Abstract:
The recently generated spirometry reference equations from the Global Lung Function Initiative (GLI2012) provide a long-awaited opportunity for the adoption of a globally applicable set of normal reference values.

The aim of this study was to document the likely interpretative effects of changing from commonly used current spirometry reference equations to the GLI2012 equations on interpretation of test results in a clinical spirometry dataset.

The rates of obstruction (range 20.0-28.5%) and spirometric restriction (range 14.2-25.8%) were similar across the four sets of reference equations.

The highest level of agreement with the new GLI2012 equations was seen with the NHANES III equations (97.6% for obstruction and 93.6% for spirometric restriction) and the lowest with those from the ECSC (96.0 for obstruction and 92.0% for restriction).

These data can be used to estimate likely diagnostic spirometry interpretation effects in the clinical setting when switching to GLI2012 spirometry reference data.

We have found the effects on interpretation of changing to GLI2012 reference data to be minimal when changing from NHANES III and most significant when changing from ECSC reference data.