Aligning Lung Function Equipment and Reference Values in Adults
Aligning Lung Function Equipment and Reference Values in Adults
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DOI：
10.1159/000501283
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发表时间：
2019-09-01
期刊：
影响因子：
3.7
通讯作者：
Vanderhelst, Eef
中科院分区：
文献类型：
--
作者：
Verbanck, Sylvia;Schuermans, Daniel;Vanderhelst, Eef
背景资料：在肺功能实验室引入新设备或参考方程时，由于人群或设备的局部差异，可能会出现系统性z评分偏差。目的：提出一种可行的参考方程与肺功能仪校准方法。方法：以本实验室的两例设备转换为例，首先对转换后的40名正常青年（男20/女20; 20-30岁）进行肺功能检测。对于平均z评分超过+/- 0.5的指数，采用Global Lung Function Initiative推荐的所谓LMS方法，通过M系数的偏移或缩放因子获得调整后的参考值，并再次计算z评分。结果如下：在涉及器械死腔减少的过渡后，肺清除指数可预测地降低，导致对照组的平均（+/- SD）z评分为-1.9（+/- 1.1）;通过调整参考值与M偏移，z评分变为-0.1（+/- 1.1）。将相同的方法应用于标准肺功能设备的转换，z分数在对照组中变得以零为中心，但在跨越更宽年龄范围（20-80岁）的81名其他受试者的测试组中也变得适当对齐。结论：我们提出并验证了一种方法，用于将本地设备与在其他地方获得的参考值对齐，或在设备发生本地变化后对齐。关键是测量相对较小的年轻成人组，确定需要根据z分数进行调整的肺功能指标，以便获得可应用于整个年龄范围的实验室特定参考值。
Background: When introducing new equipment or reference equations into the lung function laboratory, systematic z-score deviations could arise due to local differences in population or equipment. Objective: To propose a workable method for aligning reference equations with lung function equipment. Method: Using two cases of equipment transition in our laboratory as a test case, we first performed lung function testing after the transition, on a control group of 40 normal young adults (20 male/20 female; 20-30 years old). For those indices with an average z-score in excess of +/- 0.5, adapted reference values were obtained by an offset or scaling factor on the M coefficient with the so-called lambda-mu-sigma (LMS) method recommended by the Global Lung Function Initiative, and the z-scores were computed again. Results: Following a transition involving instrumental dead space reduction, the lung clearance index was predictably reduced, resulting in a mean (+/- SD) z-score of -1.9 (+/- 1.1) in the control group; by adapting the reference values with an offset on M, the z-score became -0.1 (+/- 1.1). Applying the same method to a transition of standard lung function equipment, the z-scores became centered around zero in the control group, but also became properly aligned in a test group of 81 other subjects spanning a wider age range (20-80 years). Conclusions: We proposed and verified a method for aligning local equipment with reference values obtained elsewhere, or following a local change in equipment. The key is to measure a relatively small young adult group, identifying those lung function indices that need adaptation based on z-scores, in order to then obtain laboratory-specific reference values that can be applied over the entire age range.