Reference Values for Spirometry Derived Using Lambda, Mu, Sigma (LMS) Method in Korean Adults: in Comparison with Previous References

Jo, Bum Seak; Myong, Jun‐Pyo; Rhee, Chin Kook; Yoon, Hyoung Kyu; Koo, Joonhoi; Kim, Hyoung Ryoul

doi:10.3346/jkms.2018.33.e16

Cited by 7 publications

(7 citation statements)

References 28 publications

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“…[ 25 ] It was first applied in exploring the reference ranges for spirometry in 2008. [ 26 ] Instead of copying similar studies using the LMS method,[ 27 28 29 ] we did not add spline function into the reference equations according to the participants' narrow age range and small sample size. [ 30 ] Age has complex effects on lung function.…”

Section: Discussionmentioning

confidence: 99%

Spirometric Reference Equations for Elderly Chinese in Jinan Aged 60–84 Years

Tian

Liu

Wang

et al. 2018

Chinese Medical Journal

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Background:The interpretation of spirometry varies on different reference values. Older people are usually underrepresented in published predictive values. This study aimed at developing spirometric reference equations for elderly Chinese in Jinan aged 60–84 years and to compare them to previous equations.Methods:The project covered all of Jinan city, and the recruitment period lasted 9 months from January 1, 2017 to September 30, 2017, 434 healthy people aged 60–84 years who had never smoked (226 females and 208 males) were recruited to undergo spirometry. Vital capacity (VC), forced VC (FVC), forced expiratory volume in 1 s (FEV1), FEV1/FVC, FEV1/VC, FEV6, peak expiratory flow, and forced expiratory flow at 25%, 50%, 75%, and 25–75% of FVC exhaled (FEF25%, FEF50%, FEF75%, and FEF25–75%) were analyzed. Reference equations for mean and the lower limit of normal (LLN) were derived using the lambda-mu-sigma method. Comparisons between new and previous equations were performed by paired t-test.Results:New reference equations were developed from the sample. The LLN of FEV1/FVC, FEF25–75% computed using the 2012-Global Lung Function Initiative (GLI) and 2006-Hong Kong equations were both lower than the new equations. The biggest degree of difference for FEV1/FVC was 19% (70.46% vs. 59.29%, t = 33.954, P < 0.01) and for maximal midexpiratory flow (MMEF, equals to FEF25–75%) was 22% (0.82 vs. 0.67, t = 21.303, P < 0.01). The 1990-North China and 2009-North China equations predicted higher mean values of FEV1/FVC and FEF25–75% than the present model. The biggest degrees of difference were −4% (78.31% vs. 81.27%, t = −85.359, P < 0.01) and −60% (2.11 vs. 4.68, t = −170.287, P < 0.01), respectively.Conclusions:The newly developed spirometric reference equations are applicable to elderly Chinese in Jinan. The 2012-GLI and 2006-Hong Kong equations may lead to missed diagnoses of obstructive ventilatory defects and the small airway dysfunction, while traditional linear equations for all ages may lead to overdiagnosis.

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Section: Discussionmentioning

confidence: 99%

Spirometric Reference Equations for Elderly Chinese in Jinan Aged 60–84 Years

Tian

Liu

Wang

et al. 2018

Chinese Medical Journal

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“…3 Association for the Promotion of Health, Research and Education (APHRE), Yaoundé, Cameroon. 4 Faculty of Medicine and Biomedical Sciences of Garoua, University of Ngaoundéré, Garoua, Cameroon. 5 Ngambé District Hospital, Ngambé, Cameroon.…”

Section: Abbreviationsmentioning

confidence: 99%

“…These predicted values are derived from the reference equations established from the values of the normal or "healthy" population. The normal spirometric values vary considerably according to ethnicity and the absence of spirometric reference values in a population thereby resulting in the misinterpretation of spirometric results [2][3][4][5]. International recommendations also require that the predicted values of pulmonary function tests used in a given population be those derived from the normal values of that population [6,7].…”

Section: Introductionmentioning

confidence: 99%

Spirometric reference equations for Cameroonians aged 4 to 89 years derived using lambda, mu, sigma (LMS) method

et al. 2021

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Background Spirometric reference values are well known in several ethnic groups but the normative spirometric values of blacks living in Africa have been less studied. The purpose of this study is to establish normative spirometric equations from a representative population of Cameroonian children and adults and compare these equations with those developed by the Global Lung Initiative (GLI) and in Nigerians. Methods Spirometric data from healthy Cameroonians aged 4–89 years randomly collected between 2014 and 2018 were used to derive reference equations using generalized additive model for location (mu), shape (lambda) and scale (sigma). Results A total of 625 children and adolescents (290 males and 335 females) and 1152 adults (552 males and 600 females) were included in the study. The prediction equation for spirometric index was written as: M = Exp[a0 + a1*ln (Height) + a2*ln (Age) + Mspline, Mspline was age related spline contribution]. Applying the GLI standards for African Americans resulted in overall values greater than those found in our study for forced expiratory volume in 1s (FEV1) and forced vital capacity (FVC). These values were very close in children and adolescents while the values obtained with the GLI equations for African Americans were significantly higher in adults. FEV1/FVC ratio in our study was similar for adult males but lower in adult females (88% vs 85%, difference = + 3.5%) when applying Nigerian standards. Conclusions FEV1 and FVC of the Cameroonian infant and adolescent population are very close to those of black Americans. However, FEV1 and FVC of Cameroonian adults are significantly lower than those of black American adults. These equations should allow a more suitable interpretation of spirometry in the Cameroonian population.

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“…There have been continued attempts to develop the most appropriate reference equations for the Korean population. Previous studies 4 8 9 developed spirometry reference equations using the Korea National Health and Nutrition Examination Survey (KNHANES) data, while Myong et al 10 developed reference equations using the Workers’ Health Examination data.…”

Section: Introductionmentioning

confidence: 99%

A proposal of spirometry reference equations for Korean workers

Won

Lee

2022

Ann Occup Environ Med

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Background Although spirometry results can be interpreted differently depending on the reference equation used, there are no established criteria for selecting reference equations as part of the special health examinations for Korean workers. Thus, it is essential to examine the current use of reference equations in Korea, quantify their impact on result interpretation, and propose reference equations suitable for Korean workers, while also considering the environmental conditions of special health examination facilities. Methods The 213,640 results from the special health examination database were analyzed to identify changes in the ratio of measured values to reference values of lung capacity in Korean workers with changes in age or height, and changes in the agreement of interpretations with the reference equation used. Data from 238 organizations that participated in the 2018–2019 quality control assessment by the Korea Occupational Safety and Health Agency were used to identify the spirometer model and reference equations used in each special health examination facility. Results Korean special health examination facilities used six reference equations, and the rate of normal or abnormal ventilatory diagnoses varied with the reference equation used. The prediction curve of the Global Lung Function Initiative 2012-Northeast Asian (GLI2012) equation most resembled that of the normal group, but the spirometry model most commonly used by examination facilities was not compliant with the GLI2012 equation. With a scaling factor of 0.95 applied to the Dr. Choi equation, the agreement with the GLI2012 equation was > 0.81 for men and women. Conclusions We propose the GLI2012 equation as reference equation for spirometry in Korean workers. The GLI2012 equation exhibited the most suitable prediction curve against the normal lung function group. For devices that cannot use the GLI2012 equation, we recommend applying a scaling factor of 0.95 to the Dr. Choi equation.

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Reference Values for Spirometry Derived Using Lambda, Mu, Sigma (LMS) Method in Korean Adults: in Comparison with Previous References

Cited by 7 publications

References 28 publications

Spirometric Reference Equations for Elderly Chinese in Jinan Aged 60–84 Years

Spirometric Reference Equations for Elderly Chinese in Jinan Aged 60–84 Years

Spirometric reference equations for Cameroonians aged 4 to 89 years derived using lambda, mu, sigma (LMS) method

A proposal of spirometry reference equations for Korean workers

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