Interpretative consequences of adopting the global lungs 2012 reference equations for spirometry for children and adolescents. Issue 2 (20th September 2013) - Quanjer, Philip H.
Summary Objective To determine the interpretative consequences of adopting the Global Lungs 2012 (GLI‐2012) spirometric prediction equations in a pediatric hospital population. Material Spirometric records from 2, 192 white boys and 1, 842 white girls, and 412 and 334 African–American boys and girls, respectively, aged 6.0–18.0 years, treated mainly for asthma, cystic fibrosis, cough, and dyspnoea. Methods Predicted values and lower limits of normal were calculated for FEV1, FVC, and FEV1/FVC, using prediction equations from GLI‐2012, Hankinson, Knudson, Polgar, Wang, and Zapletal. Obstruction was defined as FEV1/FVC < LLN, a restrictive pattern as FEV1/FVC > LLN and FVC < LLN. Results There was good agreement for predicted values for FEV1, FVC, and FEV1/FVC from GLI‐2012, Hankinson and Wang equations within ethnic groups. A near normal FEV1 but above normal FVC contributed to a low FEV1/FVC, particularly in African–Americans. Polgar, Knudson, and Zapletal predicteds produced disparate results. A restrictive pattern occurred in 2.2–11.2% of cases, with no statistical difference between GLI‐2012 and Hankinson. Conclusions Transition from Hankinson and Wang equations to GLI‐2012 leads to grossly similar prevalence rates of abnormally low values for FEV1, FVC, and FEV1/FVC, unlike equations from Knudson, Polgar, and Zapletal. Pediatr Pulmonol. 2014; 49:118–125. © 2013 Wiley Periodicals, Inc.