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Phenotyping Mouse Pulmonary Function In Vivo with the Lung Diffusing Capacity
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Reference equations for pulmonary diffusing capacity using segmented regression show similar predictive accuracy as

Gerald Stanley Zavorsky1, Jiguo Cao2

  • 1Pulmonary Services, Department of Medicine, UC Davis, Sacramento, California, USA gerryzavorsky@gmail.com.

BMJ Open Respiratory Research
|February 17, 2022
PubMed
Summary
This summary is machine-generated.

Segmented regression models are recommended over GAMLSS for pulmonary function reference equations due to similar predictive accuracy and simplicity. This study updates reference equations for diffusing capacity for carbon monoxide (DLCO) and nitric oxide (DLNO).

Keywords:
equipment evaluationslung physiologyrespiratory measurement

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Area of Science:

  • Pulmonary Medicine
  • Biostatistics
  • Respiratory Physiology

Background:

  • Pulmonary diffusing capacity measurements are crucial for assessing lung function.
  • Existing reference equations may require updates due to advancements in measurement equipment.
  • Generalised additive models of location, scale and shape (GAMLSS) and segmented regression are statistical approaches used in developing these equations.

Purpose of the Study:

  • To compare the efficacy of GAMLSS versus segmented regression models for pulmonary diffusing capacity.
  • To update reference equations for carbon monoxide (DLCO) and nitric oxide (DLNO) diffusing capacity.
  • To investigate the impact of measurement equipment on DLCO and DLNO.

Main Methods:

  • Pooled data from five studies (n=1076) including males and females aged 5-95 years.
  • Developed reference equations for DLCO and DLNO using both GAMLSS and segmented linear regression.
  • Employed 100-fold cross-validation to compare model prediction accuracy via root-mean-square error.

Main Results:

  • GAMLSS models showed comparable or slightly worse predictive accuracy than segmented regression in both males and females.
  • The Hyp'Air Compact device yielded higher DLNO and alveolar volume (VA) measurements compared to the Jaeger MasterScreen Pro.
  • DLCO measurements were similar between devices after accounting for altitude.

Conclusions:

  • Segmented linear regression is a suitable alternative to GAMLSS for developing pulmonary function reference equations due to its simplicity and comparable accuracy.
  • Updated reference equations for DLCO and DLNO are provided.
  • Awareness of equipment-specific differences in DLNO and VA measurements is important.