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CLASS 1 Regent: Prof. Dr. Altamiro Pereira Professor: Dr. Tiago Jacinto

SPIROMETRY REFERENCE VALUES: - A SYSTEMATIC REVIEW OF STUDIES IN THE LAST DECADE -. CLASS 1 Regent: Prof. Dr. Altamiro Pereira Professor: Dr. Tiago Jacinto. INTRODUCTION TO MEDICINE 2009/2010. Research Questions. How many and how good are the studies published in the last decade?

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CLASS 1 Regent: Prof. Dr. Altamiro Pereira Professor: Dr. Tiago Jacinto

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  1. SPIROMETRY REFERENCE VALUES: - A SYSTEMATIC REVIEW OF STUDIES IN THE LAST DECADE - CLASS 1 Regent: Prof. Dr. Altamiro Pereira Professor: Dr. Tiago Jacinto INTRODUCTION TO MEDICINE 2009/2010

  2. Research Questions • How many and how good are the studies published in the last decade? • ii. Are they different in terms of methodological quality?

  3. 4Hughes, 2007 Reference values provide a point of reference to help to interpret and determine a patient’s condition: a test result is normal if it falls within the range predicted for the age, sex and height of the patient, based on large population studies 4 Introduction It is crucial to have adequate reference values when performing a test, in order to avoid misdiagnosis; Reference values are important statistical parameters to obtain medical relevant information

  4. Spirometry is an exam that allows to assess a patient’s pulmonary function using a spirometer:  The spirometer measures the volume and flow of the forced exhaled air during a period of time 2 Two reference values are commonly used: the FVC(total amount of exhaled air)and FEV1(exhaled air during the first second) 6,7 2Enright, n.d. 6Kuster, 2008 8Miller, 2007

  5. Different People have Different Values Pre-calculated values Having inappropriate reference values leads to Bad diagnostic 1,3,5,6 SYSTEMATIC REVIEW AND QUALITY ASSESSMENT 1 Baur, 1999 3Garcia-Rio, 2004 5Ip, 2006 6Kuster, 2008

  6. 9STROBE statement Aims i.Summarize data published in the last decade; ii. Analyze and rate the obtained information using the STROBE checklist 9; iii.Collect new reference values and equations iv. Propose the most suitable values for Portugal or suggesttheconduction of a study

  7. Methods

  8. Study design:Systematic review; General Methods • Data Sources (online databases): • Key words:Spirometry, Reference Values, FEV1, FVC • Procedure: • 1. Search for articles • 2. Selectandlayoutarticlesthatmeetthecriteria • 3. Rate usingthe STROBE checklist • 4. Conclusion 7Liberati, 2009

  9. Criteria

  10. QUERYAPPLICATION ON MARCH 5TH, 2010 ONLINE DATABASE QUERY USED: ARTICLES FOUND (N) ("1998"[Publication Date] : "2008"[Publication Date]) AND ("Spirometry"[tiab] AND ("Reference values"[mh] OR "Reference equations")) 218 814 (TITLE-ABS-KEY(spirometry) AND TITLE-ABS-KEY(“reference values” OR “reference equations” OR “normal values” OR “normative values”)) AND (LIMIT-TO(PUBYEAR, 2008) OR LIMIT-TO(PUBYEAR, 2007) OR LIMIT-TO(PUBYEAR, 2006) OR LIMIT-TO(PUBYEAR, 2005) OR LIMIT-TO(PUBYEAR, 2004) OR LIMIT-TO(PUBYEAR, 2003) OR LIMIT-TO(PUBYEAR, 2002) OR LIMIT-TO(PUBYEAR, 2001) OR LIMIT-TO(PUBYEAR, 2000) OR LIMIT-TO(PUBYEAR, 1999) OR LIMIT-TO(PUBYEAR, 1998)) 276

  11. Schematic representation of our work plan Research Method

  12. Procedure 1. Search for articles 2. Select and layout articles that meet the criteria

  13. VariableExtraction Data collected (SPSS software):

  14. * Find at least one study that can be applied to Portugal; Expected Results * Gather a set of adequate spirometry reference values for our country; * Expose the necessity for these kind of studies

  15. Information Sources 1. Baur, X., S. Isringhausen-Bley, et al. (1999). "Comparison of lung-function reference values." International Archives of Occupational and Environmental Health 72(2): 69-83. 2. Enright P. Testing your lungs: spirometry [Internet]. European Lung Foundation. Available from: http://www.european-lung-foundation.org 3. Garcia-Rio, F., J. M. Pino, et al. (2004). "Spirometric reference equations for European females and males aged 65-85 yrs." Eur Respir J 24(3): 397-405. 4. Hughes, J.M.B.,Interpreting pulmonary function tests [Internet] ERS Education –Your best online source of CME in respiratory medicine [2007] European Respitatory Society. Available from: http://www.ers-education.org/media/2009/pdf/103639.pdf 5. Ip, M. S.-m., F. W.-s. Ko, et al. (2006). "Updated Spirometric Reference Values for Adult Chinese in Hong Kong and Implications on Clinical Utilization" Chest 129(2): 384-392. 6. Kuster, S. P., D. Kuster, et al. (2008). "Reference equations for lung function screening of healthy never-smoking adults aged 18-80 years." Eur Respir J 31(4): 860-868. 7. Liberati, A., D. G. Altman, et al. (2009). "The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration." Journal of Clinical Epidemiology 62(10): e1-e34. 8. Miller, Martin R. Interactive Course on Spirometry Training [Internet] ERS Education –Your best online source of CME in respiratory medicine [2007] European Respitatory Society. Available from: http://www.ers-education.org/pages/default.aspx?id=326 9. Unknown. STROBE Statement - checklist of items that should be included in reports of observational study [Internet] Strobe Statement: Strengthening the reporting of observational studies in epidemiology. [2009] ISPM - University of Bern. Available from: http://www.strobe-statement.org

  16. LEITE, Ana; PEIXOTO, Cláudia; MOURA, Diana; MARTINS, Diana; FERNANDES, Luís; ALMEIDA, Maria; BRITO, Nuno; ALMEIDA, Pedro; DIOGO, Pedro; MONTEIRO, Sara; PIMENTA, Sofia Class 1; turma1intromed@gmail.com 2009/2010

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