Luiz Carlos D'Aquino, Sílvia Carla Sousa Rodrigues, João Adriano de Barros, Adalberto Sperb Rubin, Nelson Augusto Rosário Filho, Carlos Alberto de Castro Pereira

J Bras Pneumol.2010;36(4):

Continuing Education: Respiratory Physiology

Calculating the statistical limits of normal and Z-scores for pulmonary function tests

Cálculo dos limites estatísticos de normalidade e dos escores Z para testes de função pulmonar

José Alberto Neder1, Danilo Cortozi Berton2, Denis E O’Donnell1

J Bras Pneumol.2022;48(3):e20220182

Original Article

Comparative analysis and reproducibility of the modified shuttle walk test in normal children and in children with cystic fibrosis

Análise comparativa e reprodutibilidade do teste de caminhada com carga progressiva (modificado) em crianças normais e em portadoras de fibrose cística

Cristiane Cenachi Coelho, Evanirso da Silva Aquino, Dorcas Costa de Almeida, Gisele Caroline Oliveira, Roberta de Castro Pinto, Ivana Mara Oliveira Rezende, Cíntia Passos

J Bras Pneumol.2007;33(2):168-174

Objective evaluation of clubbing on shadow images of index fingers. A study of patients with pulmonary disease and of normal individuals

Avaliação objetiva do hipocratismo digital em imagens de sombra de dedo indicador; estudo em pacientes pneumopatas e em indivíduos normais

José da Silva Moreira, Nelson da Silva Porto, Ana Luiza Schneider Moreira

J Bras Pneumol.2004;30(2):126-133

Spirometry for the diagnosis of airway obstruction in patients with risk factors for COPD: the GOLD and lower limit of normal criteria

Espirometria para o diagnóstico de obstrução das vias aéreas em pacientes com fatores de risco para DPOC: os critérios GOLD e limite inferior da normalidade

Monica Grafino1, Filipa Todo-Bom1, Ana Cristina Lutas1, Jorge Cabral2, Marco Pereira1, João Valença1, Sofia Tello Furtado1

J Bras Pneumol.2021;47(6):e20210124

Objective: The identification of persistent airway obstruction is key to making a diagnosis of COPD. The GOLD guidelines suggest a fixed criterion-a post-bronchodilator FEV1/FVC ratio < 70%-to define obstruction, although other guidelines suggest that a post-bronchodilator FEV1/FVC ratio < the lower limit of normal (LLN) is the most accurate criterion. Methods: This was an observational study of individuals = 40 years of age with risk factors for COPD who were referred to our pulmonary function laboratory for spirometry. Respiratory symptoms were also recorded. We calculated the prevalence of airway obstruction and of no airway obstruction, according to the GOLD criterion (GOLD+ and GOLD-, respectively) and according to the LLN criterion (LLN+ and LLN-, respectively). We also evaluated the level of agreement between the two criteria. Results: A total of 241 individuals were included. Airway obstruction was identified according to the GOLD criterion in 42 individuals (17.4%) and according to the LLN criterion in 23 (9.5%). The overall level of agreement between the two criteria was good (? = 0.67; 95% CI: 0.52-0.81), although it was lower among the individuals = 70 years of age (? = 0.42; 95% CI: 0.12-0.72). The proportion of obese individuals was lower in the GOLD+/LLN+ category than in the GOLD+/LLN- category (p = 0.03), as was the median DLCO (p = 0.04). Conclusions: The use of the GOLD criterion appears to be associated with a higher prevalence of COPD. The agreement between the GOLD and LLN criteria also appears to be good, albeit weaker in older individuals. The use of different criteria to define airway obstruction seems to identify individuals with different characteristics. It is essential to understand the clinical meaning of discordance between such criteria. Until more data are available, we recommend a holistic, individualized approach to, as well as close follow-up of, patients with discordant results for airway obstruction.

Keywords: Pulmonary disease, chronic obstructive; Airway obstruction; Spirometry.

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Continuing Education: Respiratory Physiology

Calculating the statistical limits of normal and Z-scores for pulmonary function tests

Cálculo dos limites estatísticos de normalidade e dos escores Z para testes de função pulmonar

Original Article

Comparative analysis and reproducibility of the modified shuttle walk test in normal children and in children with cystic fibrosis

Análise comparativa e reprodutibilidade do teste de caminhada com carga progressiva (modificado) em crianças normais e em portadoras de fibrose cística

Objective evaluation of clubbing on shadow images of index fingers. A study of patients with pulmonary disease and of normal individuals

Avaliação objetiva do hipocratismo digital em imagens de sombra de dedo indicador; estudo em pacientes pneumopatas e em indivíduos normais

Spirometry for the diagnosis of airway obstruction in patients with risk factors for COPD: the GOLD and lower limit of normal criteria

Espirometria para o diagnóstico de obstrução das vias aéreas em pacientes com fatores de risco para DPOC: os critérios GOLD e limite inferior da normalidade

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