肺功能测试解释中的参考方程的进步和局限性:为照顾老年人的临床医生考虑的问题
Angela O Suen1, Nirav R Bhakta2
1Department of Medicine, Division of Pulmonary and Critical Care Medicine, 1001 Potrero Avenue, #5K1 San Francisco, CA 94110, USA; Division of Geriatrics, University of California, San Francisco, USA.
Clinics in geriatric medicine
|November 6, 2025
概括
肺功能测试 (PFTs) 需要在老年人中仔细解释,因为参考方程中的年龄偏差. 使用z-scores可以减轻这种偏见,同时从方程中删除种族可以促进健康公平.
科学领域:
- 肺部病理学 肺部病理学
- 老年医学 老年医学
- 健康 公平 卫生 公平
背景情况:
- 肺功能测试 (PFT) 对于诊断呼吸系统疾病至关重要.
- 由于与年龄相关的生理变化,在老年人中解释PFT存在挑战.
- 现有的螺旋测量参考方程往往低于老年人群.
研究的目的:
- 评估老年人PFT解释的局限性.
- 探索使用z-score来减少PFT结果中的年龄偏差的影响.
- 讨论从PFT参考方程中删除种族对临床实践和健康公平的影响.
主要方法:
- 关于年龄表示的PFT参考方程 (GLI和NHANES) 的分析.
- 在将PFT结果与参考值进行比较时评估z-score的实用性.
- 讨论从PFT方程中删除种族后临床解释的变化.
主要成果:
- 老年人在常用的螺旋计参考方程中代表性不足.
- Z-分数可以帮助最小化PFT解释中的与年龄相关的偏差.
- 从参考方程中删除种族需要在临床决策中进行调整,但促进了健康公平.
结论:
- 意识到PFT的局限性,特别是在老年人中,对于准确的诊断至关重要.
- Z-分数为减少PFT解释中的年龄偏差提供了一个有价值的工具.
- 过渡到种族中立的PFT方程需要谨慎的导航,但支持健康公平的进步.
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