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临床婴幼儿肺功能检测实践调查

Survey of clinical infant lung function testing practices.

作者信息

Peterson-Carmichael Stacey L, Rosenfeld Margaret, Ascher Simon B, Hornik Christoph P, Arets H G M, Davis Stephanie D, Hall Graham L

机构信息

Duke University Medical Center, Durham, North Carolina.

出版信息

Pediatr Pulmonol. 2014 Feb;49(2):126-31. doi: 10.1002/ppul.22807. Epub 2013 Jun 13.

Abstract

BACKGROUND

Data supporting the clinical use of infant lung function (ILF) tests are limited making the interpretation of clinical ILF measures difficult.

OBJECTIVES

To evaluate current ILF testing practices and to survey users regarding the indications, limitations and perceived clinical benefits of ILF testing.

METHODS

We created a 26-item survey hosted on the European Respiratory Society (ERS) website between January and May 2010. Notifications were sent to members of the ERS, American Thoracic Society and the Asian Pacific Society of Respirology. Responses were sought from ILF laboratory directors and pediatric respirologists. The survey assessed the clinical indications, patient populations, equipment and reference data used, and perceived limitations of ILF testing.

RESULTS

We received 148 responses with 98 respondents having ILF equipment and performing testing in a clinical capacity. Centers in North America were less likely to perform ≥50 studies/year than centers in Europe or other continents (13% vs. 41%). Most respondents used ILF data to either "start a new therapy" (78%) or "help decide about initiation of further diagnostic workup such as bronchoscopy, chest CT or serological testing" (69%). Factors reported as limiting clinical ILF testing were need for sedation, uncertainty regarding clinical impact of study results and time intensive nature of the study.

CONCLUSIONS

Clinical practices associated with ILF testing vary significantly; centers that perform more studies are more likely to use the results for clinical purposes and decision making. The future of ILF testing is uncertain in the face of the limitations perceived by the survey respondents.

摘要

背景

支持婴儿肺功能(ILF)测试临床应用的数据有限,这使得对临床ILF测量结果的解读变得困难。

目的

评估当前ILF测试的实践情况,并就ILF测试的适应症、局限性及感知到的临床益处对用户进行调查。

方法

我们于2010年1月至5月在欧洲呼吸学会(ERS)网站上创建了一项包含26个条目的调查问卷。通知发送给了ERS、美国胸科学会和亚太呼吸学会的成员。向ILF实验室主任和儿科呼吸科医生寻求回复。该调查评估了临床适应症、患者群体、所使用的设备和参考数据,以及ILF测试的感知局限性。

结果

我们收到了148份回复,其中98名受访者拥有ILF设备并以临床身份进行测试。北美地区的中心每年进行≥50项研究的可能性低于欧洲或其他大陆的中心(13%对41%)。大多数受访者使用ILF数据来“开始新的治疗”(78%)或“帮助决定是否启动进一步的诊断检查,如支气管镜检查、胸部CT或血清学检测”(69%)。被报告为限制临床ILF测试的因素包括需要镇静、研究结果的临床影响存在不确定性以及研究耗时较长。

结论

与ILF测试相关的临床实践差异很大;进行更多研究的中心更有可能将结果用于临床目的和决策。鉴于受访者所感知到的局限性,ILF测试的未来尚不确定。

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