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Impact of using stated instead of measured height upon screening spirometry
J M Parker1, T A Dillard, Y Y Phillips
1Pulmonary & Critical Care Medicine Service, Walter Reed Army Medical Center, Washington, DC 20307-5001.
American Journal of Respiratory and Critical Care Medicine
|December 1, 1994
Summary
Using self-reported height instead of measured height in spirometry significantly impacts predicted lung function values, especially in older adults. This can alter the detection and severity assessment of lung diseases like obstruction and restriction.
Area of Science:
- Pulmonary Medicine
- Clinical Physiology
Background:
- Spirometry is a key diagnostic tool for lung diseases.
- Accurate patient height is crucial for interpreting spirometry results.
Purpose of the Study:
- To investigate the impact of using stated height (HTs) versus measured height (HTm) on predicted normal values in screening spirometry.
- To assess how discrepancies in height affect clinical interpretation and disease severity assessment.
Main Methods:
- Prospective evaluation of 210 outpatients (20-89 years) undergoing spirometry.
- Collected both stated height (HTs) and measured height (HTm) for all participants.
- Analyzed differences in predicted FEV1 and FVC, and their impact on detecting restriction (reduced FVC) and obstruction (reduced FEV1/FVC ratio).
Main Results:
- The difference between stated and measured height increased with age, particularly in older adults (80-89 years).
- Using stated height led to mean differences of 3.9% for FEV1 and 4.3% for FVC across all ages, with larger discrepancies (up to 11.7%) in older patients.
- Stated height altered the detection of restriction in 17 patients and obstruction in 4 patients.
- Clinical assessment of disease severity was affected in 13.9% of obstructed and 34.4% of restricted patients, with older individuals more frequently impacted.
Conclusions:
- Using stated height instead of measured height in spirometry significantly impacts predicted normal values.
- These discrepancies can influence the clinical interpretation of spirometry, affecting abnormality detection and disease severity assessment, particularly in the elderly population.