Analysis of the percent predicted values of FEV1 using different reference value in asthmatics

1. Analysis of the percent predicted values of FEV1 using different reference value in asthmatics Barbosa M., Barbosa T., Brito T., Campos J., Carvalho L., Carvalho R., Costa A., Dias J., Dória M., Maciel C., Mosca A., Pires C., Silva F., Viana D. - t2intromed@gmail.com ADVISER Tiago António Queirós Jacinto CLASS 2 Introduction to Medicine I 2009/2010

2. Analysis of the percent predicted values of FEV1 using different reference value in asthmatics Many respiratory diseases such as asthma and COPD can be now diagnosed and also monitored using spirometry SUMMARY It analyses how well you can breathe Introduction Researchquestionsandaims Methods Expectedresults http://www.mountnittany.org/assets/images/krames/102351.jpg

3. Analysis of the percent predicted values of FEV1 using different reference value in asthmatics Respiratory diseases can be monitored using spirometry FEV1 is the amount of air breath out during the first second Reference formulas convert the values of FEV1 to a percentage whose optimal range is between 80 and 120 INTRODUCTION

4. Analysis of the percent predicted values of FEV1 using different reference value in asthmatics There are severalreference formulas The evolution, changes in society, as well as interpersonal differences (ethnicity, etc.) are not taken into account Most formulas are now obsolete INTRODUCTION

5. Analysis of the percent predicted values of FEV1 using different reference value in asthmatics RESEARCH QUESTIONS AND AIMS Explore the use of different reference values Analyze the reference values of FEV1 in asthmatics Interpret the cause of some misdiagnosis

6. Analysis of the percent predicted values of FEV1 using different reference value in asthmatics Target population: Asthmatic patients from the Allergology Department of Hospital de S. João, Porto Sampling methods: 100 asthmatic people consecutively chosen from an acute database of the Allergology Department of Hospital de S. João Inclusion criteria: The inclusion criteria are: (1) being adult, (2) being asthmatic and (3) have performed spirometry Units of analysis: Asthmaticparticipants METHODS

7. Analysis of the percent predicted values of FEV1 using different reference value in asthmatics STUDY DESIGN Observational Transversal Analytical METHODS DATA COLECTION METHODS Consecutivelycollected Same technique and instrument http://www.adinstruments.com/solutions/images_new/spirometry1.jpg

8. Analysis of the percent predicted values of FEV1 using different reference value in asthmatics VARIABLES DESCRIPTION Age (in years) Height (in cm) Weight (in kg) Gender FVC Forced vital capacity FEV1 Forced expiratory volume in one second PEFExpiratorypeakflow METHODS

9. Analysis of the percent predicted values of FEV1 using different reference value in asthmatics STATISTICAL ANALYSIS Reference equations published by Crapo et al, Knudson et al and Morris et al to calculate the FEV1 predicted value The percent predicted values of FEV1 are the result of the quotient:   (FEV1 collected through spirometry)/(FEV1 predicted value) These procedures will be accomplished using the Statistical Analysis Software SPSS METHODS

10. Analysis of the percent predicted values of FEV1 using different reference value in asthmatics METHODS *TiffeneauIndex

11. METHODS

12. Analysis of the percent predicted values of FEV1 using different reference value in asthmatics Significant differences among the results obtained by these equations in patients with asthma EXPECTED RESULTS This fact can be in the origin of misdiagnosis and errors in therapy due to different conclusions drawn when these values are compared to the optimal range of 80/120 http://topnews.in/healthcare/sites/default/files/asthma5.jpg

13. Analysis of the percent predicted values of FEV1 using different reference value in asthmatics American Thoracic Society, Lung Function Testing: Selection of references values and Interpretative Strategies; 1991.144: 1202-1218 Arabalibeik H, Khomami MH, Agin K, Setayeshi S; Classification of restrictive and obstructive pulmonary diseases using spirometry data. Tehran University of Medical Sciences, Tehran, Stud Health Technol Inform 2009. 142: 25 Collen, J. et. al., Discordance in Spirometric Interpretations using three commonly used reference equations vs National Health and Nutrition Examination Study III; 2008.134 1009-1014. Crapo, RO; Morris, AH; Gardner, RM (1981) Reference spirometric values using techniques and equipment that meet ATS recommendations. Am Rev RespirDis 123:659–664 Enright,Pl.; Testing your lungs: spirometry [Internet]; [Cited 15 October 2009], Available from: http://www.european-lung foundation.org/uploads/Document/WEB_CHEMIN_13424_1222861696.pdf Kerstjens HA, Rijcken B, Schouten JP, Postma DS; Decline of FEV1, by age and smoking status: facts, figures, and fallacies, Department of Pulmonology, University of Groningen, The Netherlands, Thorax. 1997 Sep;52(9):820-7 Knudson, RJ; Lebowitz MD; Holberg CJ et al(1983) Changes in the normal maximal expiratory flow-volume curve with growth and aging. Am Rev RespirDis 127:725–734 REFERENCES

14. Analysis of the percent predicted values of FEV1 using different reference value in asthmatics Marek W, Marek E, Mückenhoff K, Smith HJ, Kotschy-Lang N, Kohlhäufl M; Lung function in the elderly: do we need new reference values? InstitutfürArbeitsphysiologie an der Augusta-Kranken-Anstalt, Bochum, Pneumologie. 2009 Apr;63(4):235-43. Epub 2009 Apr 2. Memon MA, Sandila MP, Ahmed ST, editors. Spirometric reference values in healthy, non-smoking, urban Pakistani population, J Pak Med Assoc, 2007.57:193-195 Miller M et. al. Debating the definition of airflow obstruction: time to move on?. Dept of Medicine, University Hospital Birmingham NHS Trust, Birmingham, UK, EurRespir J 2009. 34: 527–528 Miller M et. al.  Standardization of Spirometry, EurRespir J 2005 26: 319–338 Morris, JF; Koski, A; Johnson, LC (1971) Spirometric standards for healthy nonsmoking adults. Am Rev RespirDis 103:57–67  Quadrelli S, Roncoroni A, Montiel G; Assessment of respiratory function: influence of spirometry reference values and normality criteria selection. SecciónNeumonología, Instituto de Investigaciones Médicas Alfredo Lanari, Universidad de Buenos Aires, Argentina, RespirMed. 1999 Aug;93(8):523-35 Sood A, Dawson BK, Henkle JQ, Hopkins-Price P, Quails C; Effect of change of reference standard to NHANES III on interpretation of spirometric 'abnormality'. Southern Illinois University School of Medicine, Springfield, IL 62794-9636, USA, Int J Chron Obstruct Pulmon Dis. 2007;2(3):361-7 REFERENCES

15. Analysis of the percent predicted values of FEV1 using different reference value in asthmatics Barbosa M., Barbosa T., Brito T., Campos J., Carvalho L., Carvalho R., Costa A., Dias J., Dória M., Maciel C., Mosca A., Pires C., Silva F., Viana D. - t2intromed@gmail.com ADVISER Tiago António Queirós Jacinto CLASS 2 Introduction to Medicine I 2009/2010