Predicting Long-Term Pulmonary Impairment from Five Years of Spirometry Data

Details

• Personal Author:
  Baughman, Penelope ; Enright, Paul L. ; Hnizdo, Eva
• Description:
  RATIONALE: The sensitivity (SE) and specificity (SP) of various longitudinal limits of decline applied to serial test results from spirometry monitoring programs for the detection of individuals at high risk of future impairment lack a solid evidence base. METHODS: We studied annual spirometry data from the Lung Health Study (LHS) of adult smokers with mild COPD and from two monitoring programs for workers. The absolute limit (LLDa) and relative limit (LLDr) (Occup Environ Med 2007;64:701-7) were calculated on the first 5 years of data using SPIROLA software and were then tested for their ability to predict development of moderate impairment (FEV1 <60% predicted). The ATS-recommended FEV1 decline threshold of >15%/yr (LLDats) was also tested. The likelihood ratio statistic, LR=SE/(1-SP), was used to demonstrate potential clinical usefulness of the three limits. RESULTS: LLDr performed best for predicting impairment among LHS subjects, as demonstrated by a high likelihood ratio (LR). It also performed well for the workers. One-fourth of LHS subjects and one-half of workers who later developed impairment were identified by the LLDr. LLDats performed best for the workers, but had much lower LRs for the LHS subjects. [Description provided by NIOSH]
• Subjects:
  Chronic Disease Lung Lung Diseases Occupational Health Respiratory Function Tests Respiratory System Respiratory Tract Diseases Safety
• Keywords:
  Chronic-degenerative-diseases Lung-disease Lung-disorders Lung-function Pulmonary-system-disorders Respiratory-system-disorders Spirometry Surveillance
• ISSN:
  1073-449X
• Document Type:
  Text
• Genre:
  Abstract or Summary
• Place as Subject:
  OSHA Region 3 ; West Virginia
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Division:
  DRDS - Division of Respiratory Disease Studies
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  179
• NIOSHTIC Number:
  nn:20036354
• Citation:
  Am J Respir Crit Care Med 2009 Apr; 179(Meeting Abstracts):A4538
• Email:
  goz2@cdc.gov
• Federal Fiscal Year:
  2009
• Peer Reviewed:
  False
• Source Full Name:
  American Journal of Respiratory and Critical Care Medicine
• Supplement:
  Meeting Abstracts
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:ce5c4d7bd45a0d62982ad00ec1d63037cb46691d93d0ea991ebc1e51944abb6fca1e38ce03e620846ac34ac065b57bf5bf6fa8bb6b2e91a077362af31ad32862
• Download URL:
  https://stacks.cdc.gov/view/cdc/187820/cdc_187820_DS1.pdf
• File Type:
  [PDF - 157.68 KB ]