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How to avoid misinterpreting lung function tests in children: a few practical tips
Janet Stocks1, Jane Kirkby2, Sooky Lum1
1Portex Respiratory Unit, UCL, Institute of Child Health, London, UK.
Insights
Pulmonary function tests (PFTs) are crucial for managing children
Area of Science:
- Pediatric Pulmonology and Clinical Physiology
Background:
- Pulmonary function tests (PFTs) are vital for clinical management and research in school-aged children.
- PFTs can be performed on infants and young children, but their clinical utility is not fully established.
- Interpreting PFT results meaningfully requires careful consideration of several factors.
Purpose of the Study:
- To review key considerations for the appropriate use and interpretation of pediatric pulmonary function tests.
- To guide clinicians and researchers in selecting and applying PFTs effectively in pediatric populations.
Main Methods:
- This is a review article, synthesizing existing knowledge and expert opinion.
- It addresses critical questions regarding the rationale, test selection, frequency, reliability, and feasibility of pediatric PFTs.
Main Results:
- The review highlights the need to justify the reason for performing PFTs.
- It emphasizes selecting tests that best detect specific pathophysiology.
- It discusses the importance of test repeatability, data quality, and appropriate reference equations.
Conclusions:
- Meaningful interpretation of pediatric PFTs is essential for clinical utility and research validity.
- Careful consideration of test selection, reliability, and feasibility is crucial for successful application in children.
- Further establishment of clinical utility in specialist centers is warranted.
Abstract:
Assessments of pulmonary function play an integral part in the clinical management of school age children as well as providing objective outcome measures in clinical and epidemiological research studies. Pulmonary function tests (PFTs) can also be undertaken in sleeping infants and in awake young children from 3 years of age. However, the clinical utility of such assessments, which are generally confined to specialist centres, has yet to be established. Whether requesting or undertaking paediatric PFTs, or simply reading about how these tests have been applied in research studies, it is essential to question whether results have been interpreted in a meaningful way. This review summarises some of the issues that need to be considered, including: why the tests are being performed; which tests are most likely to detect the suspected pathophysiology; how often such tests should be repeated; whether results are likely to be reliable (in terms of data quality, repeatability and the availability of suitable reference equations with which to distinguish the effects of disease from those of growth and development), and whether the selected tests are likely to be feasible in the individual child or study group under investigation.
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