Spirometry reference values: a systematic review

Turma 1

Docente: Dr. Tiago António Queirós JacintoRegente: Prof. Dr. Altamiro Pereira

INTRODUCTION TO MEDICINE 2009/2010

ARE THE SPIROMETRY REFERENCE VALUES USED IN PORTUGAL ADEQUATE?

Have the values changed in the last ten years?

Were the reference values obtained correctly?

Problem/Research Question

Introduction

Reference values are important statistical values to obtain medical

relevant information;

They vary with the age, gender,

and other characteristics determining

whether he/she is healthy or not;

It is crucial to have adequate, current and correct reference values

when performing an exam, in order to avoid misdiagnoses.

Spirometry is one of the most important medical exams

to assess the function of a person’s pulmonary capacity.

This test consists in measuring

the volume of air and flow that

has been exhaled into a

spirometer.

Two reference values are commonly used:

 Both values are

standardized (reference values for

healthy lung function) allowing the detection of

pulmonary problems by

comparison with the obtained values.

Forced Vital Capacity or FVC

Forced Expiratory Value during the first second or FEV1

Likely hypothesis: inadequate reference values are being applied in the Portuguese population

Variability of the different sets of reference values

Strong influence over the diagnostics

SYSTEMATIC REVIEW

Aims

Summarize the wide range of data that has been published in

the last decade;

Analyze and rate the obtained information using the STROBE

checklist;

Select a new set of up to date reference values and

suggest its use in Portugal.

Methods

Methods Study design: systematic review;

Data Sources (online databases):

Key words:

SPIROMETRY

FVCFEV

Reference values

QUERY (PUBMED)ARTICLES

(NO LIMITS)

ARTICLES (ENGLISH OR

PORTUGUESE)

("SPIROMETRY"[TIAB] OR "SPIROMETRY"[MESH]) AND (("REFERENCE VALUES“ AND ("FEV1” OR "FVC”)) OR ("FORCED VITAL CAPACITY” AND "FORCED

EXPIRATORY VALUE” ) OR "REFERENCE EQUATIONS” OR "NORMAL VALUES” OR "NORMATIVE VALUES”)

464 372

(“SPIROMETRY” [MESH] OR "SPIROMETRY" [TIAB]) AND "REFERENCE VALUES" 710 561

("SPIROMETRY” [TIAB] OR "SPIROMETRY" [MESH]) AND (“REFERENCE VALUES” OR “REFERENCE EQUATIONS” OR “NORMAL VALUES” OR “NORMATIVE VALUES”) 837 659

(“SPIROMETRY” [MESH] OR "SPIROMETRY" [TIAB]) AND ("REFERENCE VALUES" OR "FEV1" OR "FVC") 4031 3503

(“SPIROMETRY” [TIAB] OR "SPIROMETRY" [MESH]) AND (“REFERENCE VALUES” OR “FEV1” OR “FVC” OR “FORCED VITAL CAPACITY” OR “FORCED EXPIRATORY

VALUE” OR “REFERENCE EQUATIONS” OR “NORMAL VALUES” OR “NORMATIVE VALUES”)

4506 3934

(“SPIROMETRY” [MESH] OR “SPIROMETRY” [TIAB]) 19679 14775

Criteria

Inclusion Criteria Exclusion Criteria

  Articles written in Portuguese

or English;

Articles referring to studies performed in humans;

Articles which refer the equipment used;

Published from 1998 to 2008.

 o Articles whose full text can not

be achieved for free

o Values referring to diseased individuals

o Articles about studies with insufficient or inconclusive data.

Research MethodStart

Search

Read Title And Abstract

Is It written in Portuguese or English?

No Yes

Exclude Select and Save for further analysis

Remove Repeated Articles

Remove all not related articles

Select and Save for further analysis

Read Abstract

Apply Inclusion/Exclusion Criteria

Read Full Text By Two Reviewers

Both Decide To Include

Both Decide To Exclude

Both Do Not Agree

Include

Exclude

Read By A Third Reviewer Who Decides

To Include Or Not

Expected results

• Conclude that some reference values are outdated and

inadequate;

• Realize that inaccurate reference values lead to a wrong diagnosis of pulmonary diseases;

• Reunite a list of adequate spirometry reference values to our country.

• Improve the accuracy and reliability of pulmonary diseases diagnosis

Turma 12009/2010