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Spirometry centile charts for young Caucasian children: the Asthma UK Collaborative Initiative
Sanja Stanojevic1, Angie Wade, Tim J Cole
1Portex Unit, Respiratory Physiology and Medicine, UCL, Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK. s.stanojevic@ich.ucl.ac.uk
Insights
New spirometry prediction equations for preschool children (aged 3-7 years) provide updated reference data. These equations improve upon existing pediatric lung function data, offering better age-dependent normal limits.
Area of Science:
- Pediatric Pulmonology
- Respiratory Physiology
- Biostatistics
Background:
- Spirometry measurement advancements enable testing in children as young as 3 years.
- Current reference data for young children is limited and often based on small, population-specific samples.
- Lack of appropriate reference data hinders practical spirometry application in preschool-aged children.
Purpose of the Study:
- To collate existing spirometry reference data for children aged 3-7 years.
- To develop updated prediction equations for preschool children's lung function.
- To link these new equations with established references for older children and adults.
Main Methods:
- Utilized the Asthma UK Collaborative Initiative to gather lung function data from healthy children aged 3-7 years.
- Employed the LMS (lambda, micro, sigma) method to create spirometry centiles.
- Extended existing prediction equations to cover the 3-year age range.
Main Results:
- Developed spirometry centile charts based on the largest sample (n=3,777) of healthy young Caucasian children (3-7 years) from 15 centers in 11 countries.
- Provided a continuous reference for lung function, smoothly transitioning into adolescence and adulthood.
- Improved pediatric equations by incorporating between-subject variability for more accurate age-dependent lower limits of normal.
Conclusions:
- Presented novel prediction equations for spirometry in preschool children.
- Established a foundation for future updates to pediatric lung function references.
- Facilitated improved clinical assessment of respiratory health in young children.
Rationale:
Advances in spirometry measurement techniques have made it possible to obtain measurements in children as young as 3 years of age; however, in practice, application remains limited by the lack of appropriate reference data for young children, which are often based on limited population-specific samples.
Objectives:
We aimed to build on previous models by collating existing reference data in young children (aged 3-7 yr), to produce updated prediction equations that span the preschool years and that are also linked to established reference equations for older children and adults.
Methods:
The Asthma UK Collaborative Initiative was established to collate lung function data from healthy young children aged 3 to 7 years. Collaborators included researchers with access to pulmonary function test data in healthy preschool children. Spirometry centiles were created using the LMS (lambda, micro, sigma) method and extend previously published equations down to 3 years of age.
Measurements And Main Results:
The Asthma UK centile charts for spirometry are based on the largest sample of healthy young Caucasian children aged 3-7 years (n = 3,777) from 15 centers across 11 countries and provide a continuous reference with a smooth transition into adolescence and adulthood. These equations improve existing pediatric equations by considering the between-subject variability to define a more appropriate age-dependent lower limit of normal. The collated data set reflects a variety of equipment, measurement protocols, and population characteristics and may be generalizable across different populations.
Conclusions:
We present prediction equations for spirometry for preschool children and provide a foundation that will facilitate continued updating.
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