Pulmonary and Critical Care Division, Dept of Medicine, Intermountain Medical Center, Salt Lake City, UT, USA Both authors contributed equally
Pulmonary and Critical Care Division, Dept of Medicine, Intermountain Medical Center, Salt Lake City, UT, USA University of Utah, School of Medicine, Salt Lake City, UT, USA Both authors contributed equally.
Eur Respir J. 2016 Jul;48(1):133-41. doi: 10.1183/13993003.01711-2015. Epub 2016 Jun 10.
The diagnosis and severity categorisation of obstructive lung disease is determined using reference values. The American Thoracic Society/European Respiratory Society in 2005 recommended the National Health and Nutrition Examination Survey (NHANES) III spirometry prediction equations for patients in USA aged 8-80 years. The Global Lung Initiative 2012 (GLI 12) provided spirometry prediction equations for patients aged 3-95 years. Comparison of the NHANES III and GLI 12 prediction equations for diagnosing and categorising airway obstruction in patients in USA has not been made.We aimed to quantify the differences between NHANES III and GLI 12 predicted values in Caucasians aged 18-95 years, using both mathematical simulation and clinical data. We compared predicted forced expiratory volume in 1 s (FEV1) and lower limit of normal (LLN) FEV1/forced vital capacity (FVC) % for NHANES III and GLI 12 prediction equations by applying both a simulation model and clinical spirometry data to quantify differences in the diagnosis and categorisation of airway obstruction.Mathematical simulation revealed significant similarities and differences between prediction equations for both LLN FEV1/FVC % and predicted FEV1 There are significant differences when using GLI 12 and NHANES III to diagnose airway obstruction and severity in Caucasian patients aged 18-95 years.Similarities and differences exist between NHANES III and GLI 12 for some age and height combinations. The differences in LLN FEV1/FVC % and predicted FEV1 are most prominent in older taller/shorter individuals. The magnitude of the differences can be large and may result in differences in clinical management.
阻塞性肺疾病的诊断和严重程度分类是使用参考值确定的。美国胸科学会/欧洲呼吸学会于 2005 年推荐美国 8-80 岁患者使用国家健康和营养调查（NHANES）III 肺量计预测方程。全球肺倡议 2012 年（GLI 12）为 3-95 岁患者提供了肺量计预测方程。尚未对 NHANES III 和 GLI 12 预测方程在诊断和分类美国患者气道阻塞方面的差异进行比较。
我们旨在使用数学模拟和临床数据，量化 18-95 岁白种人患者中 NHANES III 和 GLI 12 预测值之间的差异。我们通过应用模拟模型和临床肺量计数据比较了 NHANES III 和 GLI 12 预测方程的 1 秒用力呼气量（FEV1）和正常下限（LLN）FEV1/用力肺活量（FVC）%预测值，以量化在气道阻塞的诊断和分类方面的差异。
数学模拟显示，LLN FEV1/FVC %和预测 FEV1 的预测方程之间存在显著的相似性和差异。在使用 GLI 12 和 NHANES III 诊断 18-95 岁白种人患者气道阻塞和严重程度时存在显著差异。
在某些年龄和身高组合下，NHANES III 和 GLI 12 之间存在相似性和差异。LLN FEV1/FVC %和预测 FEV1 的差异在年龄较大、身高较高/较低的个体中最为明显。差异的幅度可能很大，可能导致临床管理的差异。
