Discrepancies between pediatric laboratories in pulmonary function results from healthy children

James Paton, Caroline Beardsmore, Aidan Laverty, Caroline King, Cara Oliver, David Young, Janet Stocks

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Multi-center research studies that include pulmonary function as an objective outcome are increasingly important in pediatric respiratory medicine. The need for local controls rather than depending on published normative data for lung function remains debatable. Aims to compare pulmonary function in childhood controls with no respiratory symptoms from three centers in the United Kingdom and ascertain the extent to which current reference equations are appropriate for this population. Spirometry, plethysmographic lung volumes, and specific airways resistance (sRaw) were measured within specialized pediatric laboratories in children from three geographical locations throughout the UK (London, Leicester, and Glasgow), using identical equipment, software and standard operating procedures. Results were compared between centers and in relation to recent or commonly used UK pediatric reference values. Pulmonary function was assessed in 94 healthy children (mean (SD) age: 7.7 (0.6) years; 88% white Caucasians; ∼30 from each center). There were no significant differences in background demographics or spirometric outcomes when compared between centers. By contrast, statistically significant differences in plethysmographic lung volumes and sRaw were observed between-centers. Significant differences in relation to published reference data for white subjects were noted for FEV1 in all three centers and occasionally for other lung function measures but the differences from predicted values were small (within ± 0.5 z-score) and not clinically significant. After appropriate inter-laboratory standardization, spirometric measurements in children can be measured in different centers without evidence of systematic differences. However, even after extensive standardization procedures, plethysmographic measures appear more prone to inter-center differences and cannot, at present, be reliably compared across centers without incorporating controls at each location.
LanguageEnglish
Pages588-596
Number of pages9
JournalPediatric Pulmonology
Volume47
Issue number6
Early online date28 Oct 2011
DOIs
Publication statusPublished - Jun 2012

Fingerprint

Pediatrics
Lung
Pulmonary Medicine
Airway Resistance
Spirometry
Reference Values
Software
Demography
Equipment and Supplies
Research
Population

Keywords

  • pulmonary function tests
  • spirometry
  • inter-center differences
  • plethysmography
  • quality control
  • discrepancies
  • pulmonary function results
  • healthy children

Cite this

Paton, James ; Beardsmore, Caroline ; Laverty, Aidan ; King, Caroline ; Oliver, Cara ; Young, David ; Stocks, Janet. / Discrepancies between pediatric laboratories in pulmonary function results from healthy children. In: Pediatric Pulmonology. 2012 ; Vol. 47, No. 6. pp. 588-596.
@article{14c7840a7d184bb8879cbb2b085c5083,
title = "Discrepancies between pediatric laboratories in pulmonary function results from healthy children",
abstract = "Multi-center research studies that include pulmonary function as an objective outcome are increasingly important in pediatric respiratory medicine. The need for local controls rather than depending on published normative data for lung function remains debatable. Aims to compare pulmonary function in childhood controls with no respiratory symptoms from three centers in the United Kingdom and ascertain the extent to which current reference equations are appropriate for this population. Spirometry, plethysmographic lung volumes, and specific airways resistance (sRaw) were measured within specialized pediatric laboratories in children from three geographical locations throughout the UK (London, Leicester, and Glasgow), using identical equipment, software and standard operating procedures. Results were compared between centers and in relation to recent or commonly used UK pediatric reference values. Pulmonary function was assessed in 94 healthy children (mean (SD) age: 7.7 (0.6) years; 88{\%} white Caucasians; ∼30 from each center). There were no significant differences in background demographics or spirometric outcomes when compared between centers. By contrast, statistically significant differences in plethysmographic lung volumes and sRaw were observed between-centers. Significant differences in relation to published reference data for white subjects were noted for FEV1 in all three centers and occasionally for other lung function measures but the differences from predicted values were small (within ± 0.5 z-score) and not clinically significant. After appropriate inter-laboratory standardization, spirometric measurements in children can be measured in different centers without evidence of systematic differences. However, even after extensive standardization procedures, plethysmographic measures appear more prone to inter-center differences and cannot, at present, be reliably compared across centers without incorporating controls at each location.",
keywords = "pulmonary function tests, spirometry, inter-center differences , plethysmography , quality control, discrepancies, pulmonary function results , healthy children",
author = "James Paton and Caroline Beardsmore and Aidan Laverty and Caroline King and Cara Oliver and David Young and Janet Stocks",
year = "2012",
month = "6",
doi = "10.1002/ppul.21592",
language = "English",
volume = "47",
pages = "588--596",
journal = "Pediatric Pulmonology",
issn = "8755-6863",
number = "6",

}

Paton, J, Beardsmore, C, Laverty, A, King, C, Oliver, C, Young, D & Stocks, J 2012, 'Discrepancies between pediatric laboratories in pulmonary function results from healthy children' Pediatric Pulmonology, vol. 47, no. 6, pp. 588-596. https://doi.org/10.1002/ppul.21592

Discrepancies between pediatric laboratories in pulmonary function results from healthy children. / Paton, James; Beardsmore, Caroline; Laverty, Aidan; King, Caroline; Oliver, Cara; Young, David; Stocks, Janet.

In: Pediatric Pulmonology, Vol. 47, No. 6, 06.2012, p. 588-596.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Discrepancies between pediatric laboratories in pulmonary function results from healthy children

AU - Paton, James

AU - Beardsmore, Caroline

AU - Laverty, Aidan

AU - King, Caroline

AU - Oliver, Cara

AU - Young, David

AU - Stocks, Janet

PY - 2012/6

Y1 - 2012/6

N2 - Multi-center research studies that include pulmonary function as an objective outcome are increasingly important in pediatric respiratory medicine. The need for local controls rather than depending on published normative data for lung function remains debatable. Aims to compare pulmonary function in childhood controls with no respiratory symptoms from three centers in the United Kingdom and ascertain the extent to which current reference equations are appropriate for this population. Spirometry, plethysmographic lung volumes, and specific airways resistance (sRaw) were measured within specialized pediatric laboratories in children from three geographical locations throughout the UK (London, Leicester, and Glasgow), using identical equipment, software and standard operating procedures. Results were compared between centers and in relation to recent or commonly used UK pediatric reference values. Pulmonary function was assessed in 94 healthy children (mean (SD) age: 7.7 (0.6) years; 88% white Caucasians; ∼30 from each center). There were no significant differences in background demographics or spirometric outcomes when compared between centers. By contrast, statistically significant differences in plethysmographic lung volumes and sRaw were observed between-centers. Significant differences in relation to published reference data for white subjects were noted for FEV1 in all three centers and occasionally for other lung function measures but the differences from predicted values were small (within ± 0.5 z-score) and not clinically significant. After appropriate inter-laboratory standardization, spirometric measurements in children can be measured in different centers without evidence of systematic differences. However, even after extensive standardization procedures, plethysmographic measures appear more prone to inter-center differences and cannot, at present, be reliably compared across centers without incorporating controls at each location.

AB - Multi-center research studies that include pulmonary function as an objective outcome are increasingly important in pediatric respiratory medicine. The need for local controls rather than depending on published normative data for lung function remains debatable. Aims to compare pulmonary function in childhood controls with no respiratory symptoms from three centers in the United Kingdom and ascertain the extent to which current reference equations are appropriate for this population. Spirometry, plethysmographic lung volumes, and specific airways resistance (sRaw) were measured within specialized pediatric laboratories in children from three geographical locations throughout the UK (London, Leicester, and Glasgow), using identical equipment, software and standard operating procedures. Results were compared between centers and in relation to recent or commonly used UK pediatric reference values. Pulmonary function was assessed in 94 healthy children (mean (SD) age: 7.7 (0.6) years; 88% white Caucasians; ∼30 from each center). There were no significant differences in background demographics or spirometric outcomes when compared between centers. By contrast, statistically significant differences in plethysmographic lung volumes and sRaw were observed between-centers. Significant differences in relation to published reference data for white subjects were noted for FEV1 in all three centers and occasionally for other lung function measures but the differences from predicted values were small (within ± 0.5 z-score) and not clinically significant. After appropriate inter-laboratory standardization, spirometric measurements in children can be measured in different centers without evidence of systematic differences. However, even after extensive standardization procedures, plethysmographic measures appear more prone to inter-center differences and cannot, at present, be reliably compared across centers without incorporating controls at each location.

KW - pulmonary function tests

KW - spirometry

KW - inter-center differences

KW - plethysmography

KW - quality control

KW - discrepancies

KW - pulmonary function results

KW - healthy children

UR - http://www.scopus.com/inward/record.url?scp=84861229058&partnerID=8YFLogxK

U2 - 10.1002/ppul.21592

DO - 10.1002/ppul.21592

M3 - Article

VL - 47

SP - 588

EP - 596

JO - Pediatric Pulmonology

T2 - Pediatric Pulmonology

JF - Pediatric Pulmonology

SN - 8755-6863

IS - 6

ER -