title: The all-age spirometry reference ranges reflect contemporary Australasian spirometry.
abstract: OBJECTIVE
  Advances in statistical modelling have allowed the creation of smoothly changing spirometry reference ranges that apply across a wide age range and better define the lower limit of normal. The objective of this study was to assess the agreement of the Stanojevic 2009 all-age reference ranges to contemporary lung function data to verify the appropriateness of this reference for clinical use in Australia and New Zealand.
  
  
  METHODS
  Spirometry data from healthy Caucasians measured between 2000-2009 in Australia and New Zealand were collected. Z-scores were calculated for the standard spirometry outcomes based on the all-age reference ranges.
  
  
  RESULTS
  Spirometry from 2066 subjects aged 4-80 years (55% male) from 14 centres were eligible. Statistically, the collated contemporary dataset differed from the all-age reference ranges, but these differences were relatively small and clinically irrelevant representing differences of approximately 3% predicted. Significant differences were also observed between some centres and equipment, potentially indicating varying influence of equipment or subject selection.
  
  
  CONCLUSIONS
  Spirometry from contemporary Australasian healthy subjects fits the all-age reference ranges well. While the current study supports the use of the all-age reference ranges, the between-centre differences highlight the need for spirometry to be used in conjunction with other clinical findings.
authors.affiliation: Department of Allergy, Immunology and Respiratory Medicine, The Alfred Hospital, Melbourne, Australia.
authors.forename: Bruce R
authors.initials: BR
authors.lastname: Thompson
authors.forename: Sanja
authors.initials: S
authors.lastname: Stanojevic
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Abramson
authors.forename: Richard
authors.initials: R
authors.lastname: Beasley
authors.forename: Andrew
authors.initials: A
authors.lastname: Coates
authors.forename: Annette
authors.initials: A
authors.lastname: Dent
authors.forename: Brenton
authors.initials: B
authors.lastname: Eckert
authors.forename: Alan
authors.initials: A
authors.lastname: James
authors.forename: Sue
authors.initials: S
authors.lastname: Filsell
authors.forename: A W Bill
authors.initials: AW
authors.lastname: Musk
authors.forename: Gary
authors.initials: G
authors.lastname: Nolan
authors.forename: Barbara
authors.initials: B
authors.lastname: Dixon
authors.forename: Chris
authors.initials: C
authors.lastname: O'Dea
authors.forename: Jenni
authors.initials: J
authors.lastname: Savage
authors.forename: Janet
authors.initials: J
authors.lastname: Stocks
authors.forename: Maureen P
authors.initials: MP
authors.lastname: Swanney
authors.forename: Graham L
authors.initials: GL
authors.lastname: Hall
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008168:Lung / Q000502:physiology; D008297:Male; D008875:Middle Aged; D009520:New Zealand; D012016:Reference Values; D013147:Spirometry / Q000592:standards*; D044465:White People; D055815:Young Adult