Spirometric variability in a longitudinal study of school-age children

Area of Science:

• Pediatric Pulmonology
• Respiratory Physiology
• Public Health

Background:

• Longitudinal studies require reliable spirometry data.
• Assessing spirometric reproducibility in children is crucial for accurate lung function assessment.
• Standardized quality criteria are essential for pediatric spirometry.

Purpose of the Study:

• To evaluate spirometric reproducibility in a longitudinal study of elementary school students.
• To determine the frequency of participants meeting American Thoracic Society (ATS) quality criteria for children.
• To identify factors influencing spirometry quality and variability in a pediatric cohort.

Main Methods:

• Recruited 3,347 students (grades 3-6) for biannual spirometry over a maximum of seven evaluations.
• Performed 15,563 spirometry tests following ATS recommendations using dry rolling-seal volume spirometers.
• Analyzed data to assess quality criteria fulfillment, reproducibility, and sources of variability.

Main Results:

• Over 95% met individual ATS quality criteria on the first test; simultaneous fulfillment increased by the second test.
• Spirometry quality significantly improved from phase 1 to phase 7 due to training.
• Intratest and intertest variability were lower in boys, younger, and taller subjects, with technician performance being a significant factor.

Conclusions:

• Children over 7 years can meet ATS spirometry quality criteria after initial evaluation.
• Maintaining high-quality spirometric tests in longitudinal pediatric studies necessitates strict quality control, particularly regarding technician performance.