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Eur Respir J 2001; 17:1054
Copyright ©ERS Journals Ltd 2001

Not all laboratories are alike

C.S. Pao, P.D. Bridge and S.A. McKenzie

Dept of Paediatric Respiratory Medicine, Barts and the London NHS Trust, London, UK. Fax: 44 2073777325

To the Editor:

Klug et al. 1 have reported observer variability within and between two experienced observers of a number of lung function measurements in preschool children. One of the methods assessed was the measurement of airway resistance by the interrupter technique (Rint). In their laboratory, Rint measurements have high interobserver variability, although no systematic bias.

In our laboratory interobserver variability of Rint measurements is measured with each new observer to ensure that it is acceptable 2. Although our within-observer variability is similar to that reported by Klug et al., the between observer variability is much lower, despite differences in experience. There is no systematic bias. Klug et al. have shown a variance (2 sds of the differences between observers measurements) of 0.62 kPa·L-1·s, where ours is 0.14–0.18 kPa·L-1·s (table 1Go). Our 95% limits of agreement are therefore much narrower.


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  		Table 1 Interobserver variability

 
It is misleading to imply that interobserver repeatability for Rint is generally poor. Technical aspects of measurement and different criteria for accepting measurements both affect repeatability. Each laboratory should have its own standards for intra- and interobserver repeatability and use these to power proposed studies.

References

  1. Klug B, Nielson KG, Bisgaard H. Observer variability of lung function measurements in 2–6 yr-old children. Eur Respir J 2000;16:472–475.[Abstract]
  2. Bridge PD, Ranganathan S, McKenzie SA. Measure-ment of airway resistance using the interrupter technique in preschool children in the ambulatory setting. Eur Respir J 1999;13:792–796.[Abstract]




This Article
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