New Global Benchmarks for Diagnosis of Lung Disease

Global benchmarks for assessing lung function across the entire life span will help healthcare professionals better understand lung disease progression and help raise awareness of the disease.

Researchers at University College London (UCL; United Kingdom) and other institutions participating in the international Global Lung Function Initiative research group collected data from 74,187 healthy nonsmokers aged 3-95 years and used modern statistical methods to derive new continuous “all-age” multiethnic lung growth charts. The all-age reference equations are generalizable across many populations and are available for the following ethnic groups: Caucasians, which includes Europe, Israel, Australia, USA, Canada, Mexican Americans, Brazil, Chile, Mexico, Uruguay, Venezuela, Algeria, Tunisia; African Americans; South East Asians, which includes Thailand, Taiwan and China (including Hong Kong) south of the Huaihe River and Qinling Mountains; North East Asians which includes Korea and China north of the Huaihe River and Qinling Mountains. For individuals not represented by these four groups, or of mixed ethnic origins, a composite equation taken as the average of the above equations is provided to facilitate interpretation until a more appropriate solution is developed.

Since the GLI are not traditional equations, they require manufacturers to implement them directly into software, or for individuals to use the free desktop programs that we will provide to interpret individual test results or existing datasets. For ethnic groups not covered by the GLI equations or of mixed ethnic origins representative samples can be used to validate use of one of the four groups, and/or create an appropriate coefficient (adjustment factor) for a new group. Desktop programs for each of the above purposes have been developed. The study describing the new global benchmarks was presented at the European Respiratory Society's annual congress, held during September 2012 in Vienna (Austria).

“Correct interpretation of lung function results in the very young will enable us to identify children who are most likely to benefit from treatment and avoid unnecessary medication for those who do not need it,” said senior author professor of respiratory physiology Janet Stocks, PhD, of UCL. “Similarly with an aging population, it is essential to distinguish the impact of normal aging from that of lung disease which could benefit from treatment, in order to enhance independence and quality of life in the elderly.”

“We additionally hope that this benchmark will help to make spirometry testing the 'norm'. Many people are aware they need an ECG to test their heart, but not many people have heard of spirometry,” added Prof. Stocks. “By taking this step towards more consistent assessments, we hope we can raise awareness of the spirometry test and help to encourage people to have their lungs tested if they think they notice a problem.”

“By spotting lung conditions early, we can work towards more effective treatments and help relieve symptoms or slow progression of the disease,” added Monica Fletcher, MSc, chair of the European Lung Foundation (ELF; Sheffield, United Kingdom). “These new equations will allow patients to understand the health of their lungs and more effectively manage their condition or take steps to prevent progression or development of lung disease, such as regular exercise and giving up smoking.”

Related Links:
University College London
Global Lung Function Initiative
European Lung Foundation