title: Interpretative consequences of adopting the Global Lungs 2012 reference equations for spirometry for children and adolescents.
abstract: OBJECTIVE
  To determine the interpretative consequences of adopting the Global Lungs 2012 (GLI-2012) spirometric prediction equations in a pediatric hospital population.
  
  
  METHODS
  Spirometric records from 2,192 white boys and 1,842 white girls, and 412 and 334 African-American boys and girls, respectively, aged 6.0-18.0 years, treated mainly for asthma, cystic fibrosis, cough, and dyspnoea.
  
  
  METHODS
  Predicted values and lower limits of normal were calculated for FEV1, FVC, and FEV1/FVC, using prediction equations from GLI-2012, Hankinson, Knudson, Polgar, Wang, and Zapletal. Obstruction was defined as FEV1/FVC < LLN, a restrictive pattern as FEV1/FVC > LLN and FVC < LLN.
  
  
  RESULTS
  There was good agreement for predicted values for FEV1, FVC, and FEV1/FVC from GLI-2012, Hankinson and Wang equations within ethnic groups. A near normal FEV1 but above normal FVC contributed to a low FEV1/FVC, particularly in African-Americans. Polgar, Knudson, and Zapletal predicteds produced disparate results. A restrictive pattern occurred in 2.2-11.2% of cases, with no statistical difference between GLI-2012 and Hankinson.
  
  
  CONCLUSIONS
  Transition from Hankinson and Wang equations to GLI-2012 leads to grossly similar prevalence rates of abnormally low values for FEV1, FVC, and FEV1/FVC, unlike equations from Knudson, Polgar, and Zapletal.
authors.affiliation: Department of Pulmonary Diseases and Department of Paediatrics, Erasmus Medical Centre, Erasmus University, Rotterdam, The Netherlands.
authors.forename: Philip H
authors.initials: PH
authors.lastname: Quanjer
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Weiner
mesh_terms: D000293:Adolescent; D001741:Black or African American; D000402:Airway Obstruction / Q000175:diagnosis* / Q000503:physiopathology; D002648:Child; D003661:Decision Support Techniques; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D008297:Male; D017410:Practice Guidelines as Topic; D011237:Predictive Value of Tests; D012016:Reference Values; D012189:Retrospective Studies; D013147:Spirometry / Q000592:standards*; D014797:Vital Capacity; D044465:White People
keywords: airway obstruction; interpretive strategy; misclassification; reference equations; spirometry