Impact of switching from Caucasian to Indian reference equations for spirometry interpretation

BACKGROUND: In the absence of ethnically appropriate prediction equations, spirometry data in Indian subjects are often interpreted using equations for other ethnic populations.OBJECTIVES: To evaluate the impact of switching from Caucasian (National Health and Nutrition Examination Survey III [NHANE...

Full description

Saved in:
Bibliographic Details
Published in:The international journal of tuberculosis and lung disease 2018-03, Vol.22 (3), p.342-348
Main Authors: Chhabra, S. K., Madan, M.
Format: Article
Language:English
Subjects:
Abnormalities
Gli
Indian
Lungs
Mathematical analysis
Mathematical models
Nhanes
Nutrition
Patients
Predictions
Reference Equations
Respiratory function
Spirometry
Switching
White people
Citations: Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:BACKGROUND: In the absence of ethnically appropriate prediction equations, spirometry data in Indian subjects are often interpreted using equations for other ethnic populations.OBJECTIVES: To evaluate the impact of switching from Caucasian (National Health and Nutrition Examination Survey III [NHANES III] and Global Lung Function Initiative [GLI]) equations to the recently published North Indian equations on spirometric interpretation, and to examine the suitability of GLI-Mixed equations for this population.MATERIALS AND METHODS: Spirometry data on 12 323 North Indian patients were analysed using the North Indian equations as well as NHANES III, GLI-Caucasian and GLI-Mixed equations. Abnormalities and ventilatory patterns were categorised and agreement in interpretation was evaluated.RESULTS: The NHANES III and GLI-Caucasian equations and, to a lesser extent, the GLI-Mixed equations, predicted higher values and labelled more measurements as abnormal. In up to one third of the patients, these differed from Indian equations in the categorisation of ventilatory patterns, with more patients classified as having restrictive and mixed disease.CONCLUSION: The NHANES III and GLI-Caucasian equations substantially overdiagnose abnormalities and misclassify ventilatory patterns on spirometry in Indian patients. Such errors of interpretation, although less common with the GLI-Mixed equations, remain substantial and are clinically unacceptable. A switch to Indian equations will have a major impact on interpretation.
ISSN:1027-3719
1815-7920
DOI:10.5588/ijtld.16.0646