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Kotaniemi, Jyrki-Tapani; Kataja, Matti (2004)
Publisher: Co-Action Publishing
Journal: International Journal of Circumpolar Health
Languages: English
Types: Article
Subjects: epidemiology, lung function, reference values
Objectives. If reference values do not accurately reflect the distribution of lung function in the population, the interpretation of spirometry results may be incorrect. Differences in lung function exist between populations, which supports the use of local reference values. In Finland, the national reference values for spirometry are currently in use. The aim of this study was to assess the correlation between measured spirometric values from healthy adults and the reference values used in Finland. Methods. In the present population-based study, spirometry results were assessed in healthy adults aged 21 to 70 years in northern Finland. After exclusions for any chronic pulmonary disease or symptom, 206 men and 215 women remained in the group. We calculated regression equations for spirometric reference values in adults and compared these with European recommendations, and with the reference values currently used in Finland. Results. These comparisons revealed large differences. The linear models do not take into account the physiological changes in both young and old adults and, thus, the reference values calculated according to the European recommendations differed from the real measured results at both ends of the 20- to 70-year age scale. Moreover, values from the logarithmic Finnish reference equations also diverged from our measurements; the differences were largest in subjects younger than 30, and in elderly men. Conclusion. Differences between populations and reference equations make international comparisons difficult, and divergence between reference values and real results may lead to incorrect clinical interpretation.(Int J Circumpolar Health 2004; 63(2):129-139)Keywords: epidemiology, lung function, reference valuesObjectives. If reference values do not accurately reflect the distribution of lung function in the population, the interpretation of spirometry results may be incorrect. Differences in lung function exist between populations, which supports the use of local reference values. In Finland, the national reference values for spirometry are currently in use. The aim of this study was to assess the correlation between measured spirometric values from healthy adults and the reference values used in Finland. Methods. In the present population-based study, spirometry results were assessed in healthy adults aged 21 to 70 years in northern Finland. After exclusions for any chronic pulmonary disease or symptom, 206 men and 215 women remained in the group. We calculated regression equations for spirometric reference values in adults and compared these with European recommendations, and with the reference values currently used in Finland. Results. These comparisons revealed large differences. The linear models do not take into account the physiological changes in both young and old adults and, thus, the reference values calculated according to the European recommendations differed from the real measured results at both ends of the 20- to 70-year age scale. Moreover, values from the logarithmic Finnish reference equations also diverged from our measurements; the differences were largest in subjects younger than 30, and in elderly men. Conclusion. Differences between populations and reference equations make international comparisons difficult, and divergence between reference values and real results may lead to incorrect clinical interpretation.
  • The results below are discovered through our pilot algorithms. Let us know how we are doing!

    • 1. Quanjer PH, Dalhuisen A, van Zomeren BC. Summary 11. Moodi 6, 2004. The recommendation of the Finnish equations of reference values. Bull Eur Physiopathol Association of Clinical Physiology and the Finnish Respir 1983;19(Suppl):45-51. Association of Chest Physicians. ISSN 1456-6249
    • 2. Quanjer PH, Tammeling GJ, Cotes JE et al. Lung [in Finnish] volumes and forced ventilatory flows. Report working 12. Sovijärvi A, Malmberg P.The use of Reference Values. Party Standardization of Lung Function Tests, Euro- In: Sovijärvi A, Ahonen A, Hartiala J, Länsimies E, pean Community for Steel and Coal. Official State- Savolainen S, Turjanmaa V,Vanninen E (eds.). Clinical ment of the European Respiratory Society. Eur Physiology and Nuclear Medicine. Duodecim 2003; Respir J Suppl 1993;16:5-40. pp 275-276. ISBN 951-656-052-0 [in Finnish]
    • 3. Crapo RO, Morris AH, Gardner RM. Reference 13. Piirilä P, Lindqvist A, Rytilä P, Välimäki P, Sovijärvi A. spirometric values using techniques and equipment Which reference values should be used for foreigners that meet ATS recommendations.Am Rev Respir Dis immigrated in Finland? Suomen Lääkärilehti 1981;123(6):659-64. 2001;56:4487-4492. [in Finnish]
    • 4. Roca J, Sanchis J, Agusti-Vidal A et al. Spirometric 14. Viljanen A. Reference Values for Spirometric, Pulmoreference values from a Mediterranean population. nary Diffusing Capacity and Body Pletysmografic StuBull Eur Physiopathol Respir 1986;22(3):217-24. dies: Scand J Clin Lab Invest 1982;42(Suppl.159):5-20.
    • 5. Brandli O, Schindler C, Kunzli N, Keller R, Perruchoud 15. Kotaniemi J-T, Sovijärvi ARA, Lundbäck B. Chronic AP. Lung function in healthy never smoking adults: Obstructive Pulmonary Disease in Finland: Prevalence reference values and lower limits of normal of a and Risk factors. (submitted) Swiss population.Thorax 1996;51(3):277-83. 16. Lundbäck B.Asthma, chronic bronchitis and respira-
    • 6. Langhammer A, Johnsen R, Gulsvik A, Holmen TL, tory symptoms: prevalence and important deterBjermer L. Forced spirometry reference values for minants.The Obstructive Lung Disease in Northern Norwegian adults: the Bronchial Obstruction in Sweden Study I. Umeå University Medical DissertaNord-Trondelag Study. Eur Respir J 2001;18(5):770-9. tions 1993;387:1-118.Appendix pp I-xii.
    • 7. Glindmeyer, H.W., J. J. Lefante, C. McColloster, R. N. 17. American Thoracic Society. Standardization of spiroJones, and H.Weill. Blue-collar normative spirometric metry. 1994 update. Am J Respir Crit Care Med values for Caucasian and African-American men and 1995; 152:1107-1136. women aged 18 to 65. Am J Respir Crit Care Med 18. Hedenström H, Malmberg P, Agarwal K. Reference 1995;151:412-422 values for lung function tests in females. Regression
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    • 9. Korotzer B, Ong S, Hansen JE. Ethnic differences in equations with smoking variables. Ups J Med Sci pulmonary function in healthy nonsmoking Asian- 1986;91(3):299-310. Americans and European-Americans. Am J Respir 20. Roca J, Burgos F, Sunyer J, Saez M, Chinn S, Anto JM, Crit Care Med 2000;161(4 Pt 1):1101-8. Rodriguez-Roisin R, Quanjer PH, Nowak D, Burney P.
    • 10. Mustajbegovic J, Kern J, Schachter EN, Zuskin E, References values for forced spirometry. Group of Pavicic F, Teufel N. Ventilatory functions in Croatian the European Community Respiratory Health Survey. population in comparison with European reference Eur Respir J 1998;11(6):1354-62. values. Croat Med J 2003;44(5):614-7.
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