Reliability evaluation of lung function test reference values

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  • UMINO Takashi
    Department of Clinical Laboratory, Tsuchiura Kyodo General Hospital
  • WAKASA Nobutaka
    Department of Clinical Laboratory, Tsuchiura Kyodo General Hospital
  • ISEZAWA Mariko
    Department of Clinical Laboratory, Tsuchiura Kyodo General Hospital
  • IKEDA Satoshi
    Department of Clinical Laboratory, Tsuchiura Kyodo General Hospital
  • KAWAKAMI Naoki
    Department of Respiratory Medicine, Tsuchiura Kyodo General Hospital
  • SAITOU Kazuhito
    Department of Respiratory Medicine, Tsuchiura Kyodo General Hospital

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Other Title
  • 肺機能検査予測値に対する信頼性の検討
  • ハイ キノウ ケンサ ヨソクチ ニ タイスル シンライセイ ノ ケントウ

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Abstract

<p>Lung function test reference values are determined on the basis of gender, age, and height. Therefore, they must be reviewed regularly to accommodate changes in the living environment. In this study, we evaluated the relative reliability and systematic bias associated with vital capacity (VC), forced vital capacity (FVC), and forced expiratory volume in one second (FEV1) after the lung function test reference values reported in 2001 by the Japanese Respiratory Society were revised in 2014 (JRS2014). This study is aimed at determining the errors associated with the previous values. We also evaluated the lower limit of normal (LLN) recommended by the American Thoracic Society. On the basis of the Landis criteria, the relative reliability of these revised reference values was “Almost Perfect.” The reference values were changed as follows: VC, −0.55% to 7.59%; FVC, −2.45% to 6.25%; and FEV1, −8.48% to 3.30% in males, and VC, −1.08% to 10.33%; FVC, −0.44% to −14.55%; and FEV1, −2.28% to −14.70% in females. Using the JRS2014 reference values and LLN to detect patients with decreased VC led to a significant increase in the number of detections. The use of LLN to detect airflow obstruction in patients resulted in a significant increase in the number of detections in males but not in females. When changing reference values, it is important to determine the resultant effect after the change. Furthermore, the use of a new factor for the early detection of respiratory diseases should be considered.</p>

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