Wingelaar Thijs T, Clarijs Paul, van Ooij Pieter-Jan Am, Koch Dave Aa, van Hulst Rob A
Royal Netherlands Navy Diving Medical Centre, Den Helder, The Netherlands.
Department of Anesthesiology, Academic Medical Centre, University of Amsterdam, The Netherlands.
Diving Hyperb Med. 2018 Mar 31;48(1):17-22. doi: 10.28920/dhm48.1.17-22.
Pulmonary function testing (PFT) is an important part of dive medical examinations. Depending on the standard used to assess fitness to dive, different reference sets and fixed cut-off points are used. Reference values are part of an ongoing debate regarding the validity and accuracy related to different age groups, sex and ethnic backgrounds. The Global Lung Initiative (GLI) has provided an all-age reference set which corrects for sex and ethnicity (GLI-2012); this has had substantial impact on pulmonary medicine.
We present an algorithm that can be used to standardise analysis of PFT in divers using the GLI-2012 reference set. Differences in the analysis of PFT between the ECSC/ERS-1993 and the GLI-2012 reference values are illustrated by means of three case reports.
Using a valid database of reference values increases accuracy and might prevent additional medical investigations and/or incorrect assessment of fitness to dive. Although our algorithm needs further evaluation to ensure its validity, the preliminary results are promising. Whatever algorithm is used, we urge dive medical physicians to consider using valid reference sets when analysing PFT for assessment of fitness to dive.
肺功能测试（PFT）是潜水医学检查的重要组成部分。根据用于评估潜水适宜性的标准，会使用不同的参考值集和固定的临界值。参考值是关于不同年龄组、性别和种族背景的有效性和准确性的持续争论的一部分。全球肺倡议（GLI）提供了一个针对性别和种族进行校正的全年龄段参考值集（GLI - 2012）；这对肺病医学产生了重大影响。
我们提出一种算法，可用于使用GLI - 2012参考值集对潜水员的肺功能测试分析进行标准化。通过三个病例报告说明了欧洲煤钢共同体/欧洲呼吸学会 - 1993（ECSC/ERS - 1993）与GLI - 2012参考值在肺功能测试分析上的差异。
使用有效的参考值数据库可提高准确性，并可能避免额外的医学检查和/或对潜水适宜性的错误评估。尽管我们的算法需要进一步评估以确保其有效性，但初步结果很有前景。无论使用何种算法，我们敦促潜水医学医生在分析肺功能测试以评估潜水适宜性时考虑使用有效的参考值集。
