Spirometry in the Lung Health Study: 1. Methods and Quality Control

Enright, Paul; Johnson, Linda Cooke; Connett, John E.; Voelker, Helen; Buist, A. Sonia

doi:10.1164/ajrccm/143.6.1215

Cited by 264 publications

(161 citation statements)

References 12 publications

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“…A previous study in Latino Americans showed that asthma severity might be influenced by ancestry in Mexican Americans . Recognizing that there is no single measure that accurately captures all facets of asthma severity, pre-FEV 1 percent predicted has several advantages as a marker of asthma severity, including its objectivity and reproducibility (Enright et al 1991;Enright et al 1994;Kitch et al 2004). …”

Section: Discussionmentioning

confidence: 99%

Admixture-matched case-control study: a practical approach for genetic association studies in admixed populations

et al. 2005

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Case-control genetic association studies in admixed populations are known to be susceptible to genetic confounding due to population stratification. The transmission/disequilibrium test (TDT) approach can avoid this problem. However, the TDT is expensive and impractical for late-onset diseases. Case-control study designs, in which cases and controls are matched by admixture, can be an appealing and suitable alternative for genetic association studies in admixed populations. In this study, we applied this matching strategy when recruiting our African American participants in the Study of African American, Asthma, Genes and Environments (SAGE). Group admixture in this cohort consists of 83% African ancestry and 17% European ancestry, which was consistent with reports from other studies. By carrying out several complementary analyses, our results show that there is substructure in the cohort, but that the admixture distributions are almost identical in cases and controls, and also in cases only. We performed association tests for asthma-related traits with ancestry, and only found that FEV 1 , a measure for baseline pulmonary function, was associated with ancestry after adjusting for socio-economic and environmental risk factors (P = 0.01). We did not observe an excess of type I error rate in our association tests for ancestry informative markers (AIMs) and asthma-related phenotypes when ancestry was not adjusted in the analyses. Furthermore, using the association tests between genetic variants in a known asthma candidate gene, β 2 adrenergic receptor (β 2 AR) and ΔFEF 25-75 , an asthma-related phenotype, as an † Correspondence and reprint requests should be addressed to:

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Section: Discussionmentioning

confidence: 99%

Admixture-matched case-control study: a practical approach for genetic association studies in admixed populations

et al. 2005

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“…Spirometry was performed with a rolling seal spirometer (Spirotech 500; Spirotech, Atlanta, GA, USA), with an intensive quality-control programme [14]. Measurements were made before and 10 min after two puffs of isoproterenol (200 mg total dose) from a metered dose inhaler.…”

Section: Methodsmentioning

confidence: 99%

Bronchodilator response in the lung health study over 11 yrs

Anthonisen¹

2005

European Respiratory Journal

100

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Long-term changes in bronchodilator response in people with mild chronic obstructive pulmonary disease were assessed in this study.Changes in forced expiratory volume in one second (FEV1) in response to isoproterenol was measured in 4,194 participants in the Lung Health Study annually for 5 yrs, and again 11 yrs after study entry. Responses were quantitated in terms of mL (absolute), as per cent of the prebronchodilator value (relative), and as a per cent of the predicted normal value (% predicted).At baseline, the mean pre-bronchodilator FEV1 was 75.4% predicted, and responses were small. Relative and percentage predicted responses were similar in males and females; and correlated positively with methacholine reactivity, and negatively with smoking intensity and age. Baseline bronchodilator responses did not correlate with subsequent decline in FEV1. There was a substantial increase in response over the first year of the study, largely due to smoking cessation, with larger increases in those who stopped smoking. After the first year absolute responses changed little in those who maintained smoking cessation, but increased in those who did not. Mean relative and percentage predicted responses increased in all participants throughout the study. There was substantial annual variability of absolute response, and it was poorly reproducible in individual participants.In conclusion, smoking cessation increased bronchodilator response, and response did not predict the rate of decline of forced expiratory volume in one second.

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“…In research settings where critical oversight is provided, test quality is maintained at a high level. It is common for ATS acceptability and reproducibility criteria to be met w90% of the time in both healthy individuals and those with respiratory diseases [7][8][9]. In settings without such training and oversight, however, such as primarycare offices, good test performance is less consistent.…”

Section: Methods Of Assessing Airflow Limitation: Current Recommendatmentioning

confidence: 99%

“…Good initial technician training and regular feedback to technicians are essential elements to maintaining good test quality in research settings and these practices should also work in clinical laboratories [8]. Software developed for research studies allows spirometry quality to be assessed rapidly and electronic feedback quickly returned to the technicians performing the tests [11].…”

Section: Methods Of Assessing Airflow Limitation: Current Recommendatmentioning

confidence: 99%

Airway inflammation in COPD: physiological outcome measures and induced sputum

Crapo

Jensen²,

Hargreave³

2003

European Respiratory Journal

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Chronic obstructive pulmonary disease (COPD) is a result of airway inflammation, and the best predictor of COPD is the early detection of airflow limitation by spirometry. The Global Initiative for Obstructive Lung Disease Workshop Report defines airflow limitation using simple spirometric indices. Available guidelines categorise the severity of COPD using forced expiratory volume in one second (FEV1) and forced vital capacity (FVC), with symptoms playing a minor role in the assessment.Current standards define COPD by progressive loss of FEV1, and thus longitudinal decline in FEV1 will be the primary outcome variable for intervention studies aimed at preventing or reducing the loss of pulmonary function. There is evidence, however, that the variable FEV1/FVC and FEV1 are often not measured properly in all settings.This article will discuss the roles of physiological measurements in diagnosing COPD and physiological outcome measures for COPD. It does not formally compare physiological measures with other outcome measures, such as symptoms or quality of life. Additionally, improved treatment of established disease requires a better understanding of the inflammatory process and its clinical effects and treatment.The inflammatory process, and how drugs affect it, can be studied noninvasively or relatively noninvasively by using refined methods of examining spontaneous or induced sputum. Enhanced understanding of the use of induced sputum will assist in predicting patients9 responses to short-and long-term inhaled corticosteroid treatment, and the methods of sputum examination need to be simplified so that they can be applied more easily to clinical practice. Eur Respir J 2003; 21: Suppl. 41, 19s- Chronic obstructive pulmonary disease (COPD) is defined by the Global Initiative for Obstructive Lung Disease (GOLD) as a "disease state characterised by airflow limitation that is not fully reversible. …The airflow limitation is usually both progressive and associated with an abnormal inflammatory response of the lungs to noxious particles or gases" [1]. The absence of reversibility tends to exclude asthma by definition, although asthma can coexist with COPD. Methods of assessing airflow limitation: current recommendations and their limitationsAvailable guidelines categorise the severity of COPD primarily by using forced expiratory volume in one second (FEV1), whereas symptoms play a minor role in the assessment [1][2][3][4][5]. This tight link between FEV1 and COPD reflects the fact that spirometry is the standard for defining the presence of airway obstruction and the progressive loss of FEV1, the physiological variable that characterises COPD severity and predicts its mortality. Spirometry has become the standard, in part, because good quality and inexpensive tests are widely available.The GOLD Workshop Report explicitly defines airflow limitation using simple spirometric indices. Specifically, airflow limitation is defined as an FEV1/forced vital capacity (FVC)v70% and a postbronchodilator FEV1v80% of predict...

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Spirometry in the Lung Health Study: 1. Methods and Quality Control

Cited by 264 publications

References 12 publications

Admixture-matched case-control study: a practical approach for genetic association studies in admixed populations

Admixture-matched case-control study: a practical approach for genetic association studies in admixed populations

Bronchodilator response in the lung health study over 11 yrs

Airway inflammation in COPD: physiological outcome measures and induced sputum

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