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Predictive equations that fit adults

The SpirXpert software package presents ample choice of predictive equations for adults. It is probably the only software that allows the user to compare graphically predicted values due to different authors, and to ascertain how well predicted values for children and adolescents connect to those for adults. The following prediction equations for adults are at the present time included in the software:

  1. Stanojevic S, Wade A, Stocks J, Hankinson J, Coates AL, Pan H, Rosenthal M, Corey M, Lebecque P, Cole TJ. Reference ranges for spirometry across all ages. A new approach. Am J Respir Crit Care Med 2008; 177: 253–260.
  2. Brändli O, Schindler Ch, Künzli N, Keller R, Perruchoud AP, and SAPALDIA team. Lung function in healthy never smoking adults: reference values and lower limits of normal of a Swiss population. Thorax 1996; 51: 277-283.
    Brändli O, Schindler Ch, Leuenberger PH, Baur X, Degens P, Künzli N, Keller R, Perruchoud AP. Letters to the editor. Re-estimated equations for 5th percentiles of lung function variables. Thorax 2000; 55: 172.
  3. Crapo RO, Morris AH, Gardner RM. Reference spirometric values using techniques and equipment that meet ATS recommendations. Am Rev Respir Dis 1981; 123: 659-664.
  4. ECCS/ERS: Quanjer PhH, Tammeling GJ, Cotes JE, Pedersen OF, Peslin R, Yernault JC. Lung volumes and forced ventilatory flows. Eur Respir J 1993; 6 suppl. 16: 5-40.
    ECCS/ERS adjusted. Erratum Eur Respir J 1995; 8: 1629.
  5. Enright PL, Kronmal RA, Higgins M, Schenker M, Haponik EF. Spirometry reference values for women and men 65 to 85 years of age. Cardiovascular Health Study. Am Rev Respir Dis 1993; 147: 125-133.
  6. Falaschetti E, Laiho J, Primatesta P, Purdon S: Prediction equations for normal and low lung function from the Health Survey for England. Eur Respir J 2004; 23: 456-463 .
  7. Forche G, Stadlober E, Harnoncourt K: Neue spirometrische Bezugswerte für Kinder, Jugendliche und Erwachsene. Ost. Ärztezeitung 1988; 43, 15/16, 40-42.
  8. Gore CJ, Crockett AJ, Pederson DG, Booth ML, Bauman A, Owen N. Spirometric standards for healthy adult lifetime nonsmokers in Australia. Eur Respir J 1995; 8: 773-782.
  9. Hankinson JL, Odencrantz JR, Fedan KB. Spirometric reference values from a sample of the general US population. Am J Respir Crit Care Med 1999; 159: 179-187.
  10. Hedenström H, Malmberg P, Fridrikson H. Reference values for lung function tests in men: regression equations with smoking variables. Upsala J Med Sci 1986; 91: 299-310.
  11. Knudson RJ, Lebowitz MD, Holberg CJ, Burrows B: Changes in the normal maximal expiratory flow-volume curve with growth and aging. Am Rev Respir Dis 1983; 127: 725-734.
  12. Langhammer A, Johnsen R, Gulsvik A, Holmen TL, Bjermer L. Forced spirometry reference values for Norwegian adults: the Bronchial Obstruction in Nord-Trøndelag study. Eur Respir J 2001; 18: 770-779.
  13. Min-Chien Wu. Study on maximal expiratory flow and volume in Chinese. I. Normal nonsmoking adults. J Formosan Med Assoc 1961; 80: 19-29.
  14. Pereira (Brazilian population).
  15. Quanjer PhH, Tammeling GJ, Cotes JE, Pedersen OF, Peslin R, Yernault JC. Lung volume and forced ventilatory flows. Report ECCS Working Party Standardization of lung function tests. Official Statement European Respiratory Society. Eur Respir J 1993; 6 Suppl 16: 15-40.
  16. Roca J, Sanchis J, Agusti-Vidal A, Segarra F, Navajas D, Rodriguez-Roisin R, Casan P, Sans S. Spirometric reference values from a Meditteranean population. Bull Eur Physiopathol Respir 1986; 22: 217-224.
  17. Viljanen AA, Halttunen PK, Kreus K-E, Viljanen BC. Spirometric studies in nonsmoking, healthy adults. Scan J Clin Lab Invest 1982; 42, suppl. 159: 5-20..

The ECSC/ERS prediction equations for FEV1, FVC and FEV1%FVC tend to predict too low values, a finding corroborated by e.g. Brändli, Falaschetti, Langhammer and by a study performed in the Netherlands. The adjusted ECCS/ERS equations that fit the Dutch population, and which are available in the SpirXpert software package, are as follows:

FEV1 1.08·(3.95·height – 0.025·age – 2.60) L RSD = 0.38
FVC 1.15·(4.43· height – 0.026·age – 2.89) L RSD = 0.38
FEV1%FVC 89.1 – 0.19·age RSD = 6.51

FEV1 1.08·(4.30· height – 0.029·age – 2.49) L RSD = 0.51
FVC 1.10·(5.76· height – 0.026·age – 4.34) L RSD = 0.61
FEV1%FVC 87.2 – 0.18·age RSD = 7.17

Standing height in m, age in yr.
The RSD is the residual standard deviation, i.e. standard deviation about the predicted values after allowing for age and height. Substitute 25 yr in the equations for any adult under 25 yr.

See also:
13 sets of reference values for children and adolescents
SpirXpert software

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