ATS Pulmonary Function Laboratory Manual

ATS Pulmonary Function Laboratory Management & Procedure Manual | 3rd Edition

2.3. Use ethnic group specific reference equations whenever possible. Each patient should determine their own ethnic grouping; technicians should not determine ethnic group based on physical char- acteristics of the patient such as skin color, or language. This approach is known to lead to errors. In addition, asking individuals to specify their race/ethnic group conforms to the NHANES III method and therefore establishes a better link to the use of the NHANES III equations. 2.3.1. The use of race/ethnic specific reference studies is the preferred method. Problems with this approach include: a. Finding a good reference study for each specific ethnic group b. Dealing with patients of multi-ethnic background. 2.3.2. The problems in applying racial/ethnic adjustment factors to equations based on Caucasian subjects include: a. One factor may not be appropriate for all PF test values; b. Knowing or determining correction factors for different ethnic groups; c. Knowing how a specific computer program has modified the reference values for an ethnic difference (if applicable to the specific device used for testing); d. Dealing with patients of multi-ethnic background. 2.3.3. Use the laboratory’s chosen reference equations and indicate the possible effects of ethnic group when interpreting results. 3. Test “turnaround time” (8) 3.1. An interim, uninterpreted report is available immediately post-test. 3.2. An interpreted copy of the test results is available within 48 hours. 4. Summary interpretation and/or impression 4.1. One approach is to assess or interpret the values (low, normal, high, etc.), and then form an impres- sion as to what the values mean. Suggest characteristic patterns of dysfunction (i.e., obstructive versus restrictive). 4.2. Observe the patterns in relation to all tests performed. 4.3. Compare present results to previous test results (if applicable) (13). References 1. American Thoracic Society. Lung function testing: selection of reference values and interpretative strategies. Am Rev Respir Dis 1991;144:1202–1218. 2. Crapo RO. Reference values for lung function tests. Respir Care 1989;34:626–638. 3. Becklake MR. Concepts of normality applied to the measurement of lung function. Am J Med 1986;80:1158–1163. 4. Pellegrino R, Viegi G, Brusasco V, et al . Interpretative strategies for lung function tests. Eur Respir J 2005;26:948–968. 5. Quanjer PH. Standardized lung function testing. Bull Eur Physiopathol 1983;19:45–51. 6. Quanjer PH, Stanojevic S, Cole TJ, et al . Multi-ethnic reference values for spirometry for the 3-95-yr range: the global lung function 2012 equations. Eur Respir J 2012;40:1324–1343. 7. Hankinson JL, Odencrantz JR, Fedan KB. Spirometric reference values from a sample of the general U.S. population. Am J Respir Crit Care Med 1999;159:179–187. 8. Clausen JL. Prediction of normal values. In: Clausen JL, editor. Pulmonary function testing: guide- lines and controversies. New York: Academic Press; 1982. pp. 49–59.

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