Pulmonary function tests in indian girls
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《美国医学杂志》
Department of Paediatrics,University of Oxford, United Kingdom
In the article Pulmonary function tests in Indian girls- Prediction equations the authors state. These equations can be used largely to calculate the pulmonary functions in girls, anywhere in India (both urban and rural populations). In view of the large sample size and diverse background of the subjects, the data of the present study can be considered as referral standards for Indian girls in particular and also for south Asian countries'.
I seek clarification on how the prediction equations, derived from children in 2 schools in Hyderabad, can be extrapolated to other regions in India. An inclusion critera of different mother tongues as a representation of all geographic areas is invalid unless there is a history of recent migration, as the nutritional status, environmental determinants and the socio-economic factors of these children will be comparable to the local population. It has been reported that nutritional status, related to socio-economic class, affects PEFR significant.[1]
There is no justification to generalize the findings to both urban and rural populations' since it is known that PEFR differs between urban and rural children of the same height.[2]
It is also known that PEFR is different between North Indian and South Indian children as a result of different chest circumference between the races. The idea of establishing prediction equations for PEFR using independent variables is to utilise them for the diagnosis of obstructive lung disease, mainly bronchial asthma and to assess improvement with treatment, in areas where other tests of lung function are unavailable. In this context, it is unreasonable to include inspiratory and expiratory chest circumference as an independent predictor of PEFR. While it may correlate well in healthy children, it could be unreliable to measure and interpret in an acute attack of bronchial asthma. Similarly, FYM measurement for the diagnosis of acute asthma using PEFR sounds unreasonable and impractical. Considering this, only height from the present study can be reliably utilised for the prediction of PEFR in South Indian school children, which has already been established ina study of 5477 children in the same geographic region.[3]
While it is vital to establish prediction equations for those regions where access to other diagnostic modalities for asthma are limited, it is equally important to consider the characteristics unique to the local population where PEFR is measured viz. anthropometric differences, socio-economic variability etc.
References
1. Ong TJ, Mehta A, Ogston S, Mukhopadhyay S. Prediction of lung function in the inadequately nourished. Arch Dis Child 1998; July; 79(1) : 18-21.
2. Sharma R, Jain A, Arya A, Chowdhary BR. Peak expiratory flow rate of school going rural children aged 5-14 years from Ajmer district. Indian Pediatr 2002 Jan; 39(1) : 75-78.
3. Paramesh H. Normal peak expiratory flow rate in urban and rural children. Indian J Pediatr 2003 May; 70(5) : 375-377(Sebastian Anoop)
In the article Pulmonary function tests in Indian girls- Prediction equations the authors state. These equations can be used largely to calculate the pulmonary functions in girls, anywhere in India (both urban and rural populations). In view of the large sample size and diverse background of the subjects, the data of the present study can be considered as referral standards for Indian girls in particular and also for south Asian countries'.
I seek clarification on how the prediction equations, derived from children in 2 schools in Hyderabad, can be extrapolated to other regions in India. An inclusion critera of different mother tongues as a representation of all geographic areas is invalid unless there is a history of recent migration, as the nutritional status, environmental determinants and the socio-economic factors of these children will be comparable to the local population. It has been reported that nutritional status, related to socio-economic class, affects PEFR significant.[1]
There is no justification to generalize the findings to both urban and rural populations' since it is known that PEFR differs between urban and rural children of the same height.[2]
It is also known that PEFR is different between North Indian and South Indian children as a result of different chest circumference between the races. The idea of establishing prediction equations for PEFR using independent variables is to utilise them for the diagnosis of obstructive lung disease, mainly bronchial asthma and to assess improvement with treatment, in areas where other tests of lung function are unavailable. In this context, it is unreasonable to include inspiratory and expiratory chest circumference as an independent predictor of PEFR. While it may correlate well in healthy children, it could be unreliable to measure and interpret in an acute attack of bronchial asthma. Similarly, FYM measurement for the diagnosis of acute asthma using PEFR sounds unreasonable and impractical. Considering this, only height from the present study can be reliably utilised for the prediction of PEFR in South Indian school children, which has already been established ina study of 5477 children in the same geographic region.[3]
While it is vital to establish prediction equations for those regions where access to other diagnostic modalities for asthma are limited, it is equally important to consider the characteristics unique to the local population where PEFR is measured viz. anthropometric differences, socio-economic variability etc.
References
1. Ong TJ, Mehta A, Ogston S, Mukhopadhyay S. Prediction of lung function in the inadequately nourished. Arch Dis Child 1998; July; 79(1) : 18-21.
2. Sharma R, Jain A, Arya A, Chowdhary BR. Peak expiratory flow rate of school going rural children aged 5-14 years from Ajmer district. Indian Pediatr 2002 Jan; 39(1) : 75-78.
3. Paramesh H. Normal peak expiratory flow rate in urban and rural children. Indian J Pediatr 2003 May; 70(5) : 375-377(Sebastian Anoop)