1. Defining ‘healthy’ in preschool-aged children for forced oscillation technique reference equations
- Author
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Bence Radics, Robert S. Ware, Peter D. Sly, Zoltán Hantos, Keith Grimwood, Dorottya Czovek, and Claire Shackleton
- Subjects
Pulmonary and Respiratory Medicine ,Spirometry ,Pediatrics ,medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Model fitting ,medicine.disease ,Mutually exclusive events ,03 medical and health sciences ,0302 clinical medicine ,Forced Oscillation Technique ,030228 respiratory system ,Respiratory impedance ,Wheeze ,medicine ,Mixed effects ,030212 general & internal medicine ,medicine.symptom ,business ,Asthma - Abstract
Background and objective Selecting ‘healthy’ preschool-aged children for reference ranges may not be straightforward. Relaxing inclusion criteria for normative data does not affect spirometry z-scores. We therefore investigated the effect of similarly relaxing inclusion criteria in preschoolers on reference ranges for respiratory impedance (Zrs) using a modified forced oscillation technique (FOT). Methods The International Study of Asthma and Allergies in Childhood questionnaire classified 585 children into a healthy and five mutually exclusive groups. Zrs was measured between 4 and 26 Hz and resistance (R) and compliance (C) obtained by model fitting. Prediction models were determined using mixed effect models and z-scores compared between healthy children and the five groups. Results Zrs data were obtained for 494 participants (4.30 ± 0.7 years) on 587 occasions. Comparison of the Zrs z-scores between the healthy children and the health groups found significant differences in children with asthma, current wheeze and respiratory symptoms, but not in children born preterm or with early-life wheeze. Adding these two groups to the healthy dataset had no significant effect on the distribution of z-scores and increased the size of the dataset by 22.3%. Conclusion Our data suggest that preschool-aged children born preterm or with early-life wheeze can be included in FOT reference equations, while those with asthma, current wheeze and respiratory symptoms within 4 weeks of testing should be excluded. This more inclusive approach results in more robust FOT reference ranges. more...
- Published
- 2017
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