Agreement between fixed-ratio and lower limit of normal spirometry interpretation protocols decreases with age: is there a need for a new GOLD standard

Details

• Personal Author:
  Czeczok T ; Fuortes LJ ; Gerke AK ; Laney AS ; Lourens S ; Mikulski MA ; Sprince NL
• Description:
  Objectives: To assess concordance between the fixed 70% ratio cutoff point with the fixed percent predicted values (Fixed-ratio) and the lower limit of normal (LLN) algorithms in interpreting spirometry results in an older population. Methods: Spirometries were interpreted using Third National Health and Nutrition Examination Survey reference equations for 2319 workers. Results: The Fixed-ratio algorithm characterized 34.5% (n = 801) results as abnormal, compared with 29.7% (n = 689) by the LLN. There were almost twice as many obstructive and mixed airways spirometries identified under the Fixed-ratio compared to LLN. Rates of restrictive pattern physiology were virtually the same under each algorithm. Overall agreement between the algorithms decreased with age from "almost perfect" for those younger than 60 years to "substantial" for those older than 80 years. Conclusions: This study found age-related discordance between two algorithms possibly related to the lack of reference equations and standards for individuals older than 80 years. [Description provided by NIOSH]
• Subjects:
  Age Factors Lung Occupational Health Respiratory Function Tests Respiratory System Respiratory Tract Diseases Safety Surveys And Questionnaires
• Keywords:
  Age-factors Airway-obstruction Analytical-instruments Analytical-processes Health-surveys Lung-function Mathematical-models Measurement-equipment Physiology Pulmonary-function-tests Respiratory-system-disorders Spirometry Standards Statistical-analysis Surveillance Testing-equipment

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• ISSN:
  1076-2752
• Document Type:
  Text
• Genre:
  Journal Article
• Place as Subject:
  Iowa ; OSHA Region 3 ; OSHA Region 7 ; 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:
  55
• Issue:
  7
• NIOSHTIC Number:
  nn:20042913
• Citation:
  J Occup Environ Med 2013 Jul; 55(7):802-808
• Contact Point Address:
  Marek Mikulski, MD, PhD, MPH, The University of Iowa, 2213 Westlawn, Iowa City, IA 52242
• Email:
  marek-mikulski@uiowa.edu
• Federal Fiscal Year:
  2013
• Peer Reviewed:
  True
• Source Full Name:
  Journal of Occupational and Environmental Medicine
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:bc8eedfa18542893ce356b3c082b59090a1be894959a67cfdccf807e4196e76c5fc486caf239bb868cd46c4f3052894b10845515bd57a592c524e2ef618c3927
• Download URL:
  https://stacks.cdc.gov/view/cdc/194981/cdc_194981_DS1.pdf
• File Type:
  [PDF - 111.33 KB ]