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Title: Effects of adopting the Global Lung Function Initiative 2017 reference equations on the interpretation of carbon monoxide transfer factor.
Austin Authors: Brazzale, Danny J ;Seccombe, Leigh M;Welsh, Liam;Lanteri, Celia J;Farah, Claude S;Ruehland, Warren R 
Affiliation: Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia
Thoracic Medicine, Concord Repatriation General Hospital, Concord, Australia
Faculty of Medicine and Health, University of Sydney, Australia
Department of Respiratory and Sleep Medicine, Austin Health, Heidelberg, Victoria, Australia
Department of Respiratory and Sleep Medicine, Royal Children's Hospital, Melbourne, Australia
Murdoch Children's Research Institute, Melbourne, Australia
Issue Date: 27-May-2020 2020-03-05
Publication information: The European respiratory journal 2020; 55(5): 1901905
Abstract: The recently published Global Lung Function Initiative (GLI) carbon monoxide transfer factor (TLCO) reference equations provide an opportunity to adopt a current, all-age, widely applicable reference set. The aim of this study was to document the effect of changing to GLI from commonly utilised reference equations on the interpretation of TLCO results.33 863 TLCO results (48% female, 88% Caucasian, n=930<18 y) from clinical pulmonary function laboratories within three Australian teaching hospitals were analysed. The lower limit of normal (LLN) and proportion of patients with a TLCO below this value were calculated using GLI and other commonly used reference equations.The average TLCO LLN for GLI was similar or lower than the other equations, with the largest difference seen for Crapo equations (median: -1.25, IQR: -1.64, 0.86 mmol·min-1·kPa-1). These differences resulted in altered rates of reduced TLCO for GLI particularly for adults (+1.9% versus Miller to -27.6% versus Crapo), more so than for children (-0.8% versus Kim to -14.2% versus Cotes). For adults, the highest raw agreement for GLI was with Miller equations (94.7%), while for children it was with Kim equations (98.1%). Results were reclassified from abnormal to normal more frequently for younger adults, and for adult females, particularly when moving from Roca to GLI equations (30% of females versus 16% of males).The adoption of GLI TLCO reference equations in adults will result in altered interpretation depending on the equations previously used and to a greater extent in adult females. The effect on interpretation in children is less significant.
DOI: 10.1183/13993003.01905-2019
ORCID: 0000-0003-2489-227X
PubMed URL: 32139466
Type: Journal Article
Appears in Collections:Journal articles

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