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Prediction equations for normal and low lung function from the Health Survey for England

E. Falaschetti, J. Laiho, P. Primatesta, S. Purdon
European Respiratory Journal 2004 23: 456-463; DOI: 10.1183/09031936.04.00055204
E. Falaschetti
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J. Laiho
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P. Primatesta
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S. Purdon
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  • Fig. 1.—
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    Fig. 1.—

    Age dependency of forced expiratory volume in one second (FEV1) (a, c) and forced vital capacity (FVC) distribution (b, d) in males (a, b) and females (c, d). Each subject is represented by a dot (–––: smoothed values (lowess)).

  • Fig. 2.—
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    Fig. 2.—

    Predicted mean (––––) and fifth percentile (═) for forced expiratory volume in one second (FEV1) (a, d), forced vital capacity (FVC) (b, e) and FEV1/FVC (c, f) in males (height 175 cm) (a–c) and females (height 165 cm) (d–f) by age.

  • Fig. 3.—
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    Fig. 3.—

    Observed (▪) and predicted (•) mean forced vital capacity (FVC) in present study and European Coal and Steel Community reference values (▴) by age in a) males and b) females.

  • Fig. 4.—
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    Fig. 4.—

    Comparison of mean predicted forced expiratory volume in one second (FEV1) (a, c) and forced vital capacity (FVC) (b, d) by age in males (a, b) and females (c, d) in present study (▵) and studies of BrÄndli et al. 1 (▪), Langhammer et al. 13 (♦) and Hankinson et al. 14 (○).

  • Fig. 5.—
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    Fig. 5.—

    Comparison of mean predicted forced expiratory volume in one second (FEV1)/forced vital capacity (FVC) by age in a) males and b) females in the present study (▴) and studies of BrÄndli et al. 1 (▪), Langhammer et al. 13 (♦), Hankinson et al. 14 (•) and European Coal and Steel Community 4 (▾).

Tables

  • Figures
  • Table 1

    Reference sample selection criteria and characteristics of the study sample

    MalesFemales
    Participants (White) interviewed n
     Total1388316646
     Less invalid spirometry data1185413554
     Less ever smokers46436845
     Less nonhealthy subjects31074195
     Less irreproducible data24973556
    Age in years n
     16–24424507
     25–34620802
     35–44583750
     45–54376593
     55–64260416
     65–74157329
     75–8451134
     ≥85825
    Age last birthday yrs40±15.743±17.0
    Height cm176±6.8162±6.4
    FEV1 L4.1±0.812.9±0.65
    FVC L5.0±0.943.5±0.74
    FEV1/FVC0.82±0.0720.83±0.071
    • Data are presented as absolute values or mean±sem

    • FEV1: forced expiratory volume in one second

    • FVC: forced vital capacity

  • Table 2

    Coefficients from prediction equations for normal lung function measures by sex

    b 0 b 1 b 2 b 3
    Corresponding variableInterceptAA2ln H
    ln FEV1 L
    Males (R2=0.59; σ=0.14)
     Mean
      Age ≤25 yrs−10.411860.09569−0.002212.10839
      Age >25 yrs−9.376740.00183−0.000112.10839
     LLN
      Age ≤25 yrs−10.758200.10320−0.002312.10839
      Age >25 yrs−9.723080.00933−0.000212.10839
    Females (R2=0.69; σ=0.14)
     Mean−8.497170.00422−0.000151.90019
     LLN−8.684670.00495−0.000181.90019
    ln FVC L
    Males (R2=0.52; σ=0.14)
     Mean
      Age ≤25 yrs−11.451460.09895−0.002162.32222
      Age >25 yrs−10.367060.00434−0.000112.32222
     LLN
      Age ≤25 yrs−11.632300.09795−0.002172.32222
      Age >25 yrs−10.547900.00334−0.000122.32222
    Females (R2=0.62; σ=0.15)
     Mean−9.669990.00837−0.000172.14118
     LLN−9.849410.00772−0.000182.14118
    ln FEV1/FVC
    Males (R2=0.15; σ=0.08)
     Mean1.03981−0.003940.00002−0.21653
     LLN0.826210.00101−0.00005−0.21653
    Females (R2=0.16; σ=0.08)
     Mean1.15822−0.004150.00002−0.23815
     LLN1.00699−0.00196−0.00001−0.23815
    • Model: mean lung function=eb0+b1A+b2A2+b3ln H

    • For example, a male aged 31 yrs with a height of 173 cm would have a predicted forced expiratory volume in one second (FEV1) of 4.53 L (from e−9.37674+(0.00183×31)−(0.00011×312)+2.10839ln173), and a predicted forced vital capacity (FVC) of 5.48 L (from e−10.36706+(0.00434×31)−(0.00011×312)+2.32222ln173)

    • R2: fraction of explained variance

    • σ: sd of residuals

    • LLN: lower limit of normal

    • A: age

    • H: height

  • Table 3

    Percentage of population with lung function below the lower limit of normal in “healthy” population for the Health Survey for England reference curves using different estimates of the 5th percentile by sex and age group

    Age yrsPresent model#Mean – 1.645σ
    FEV1FVCFEV1FVC
    Males
     16–244.05.04.54.0
     25–345.85.05.03.9
     35–446.36.05.36.3
     45–543.55.14.36.6
     55–643.13.86.96.9
     65–746.46.412.110.8
     ≥755.15.18.515.3
     All5.05.25.65.9
    Females
     16–245.56.13.03.7
     25–344.65.73.23.2
     35–446.34.44.94.1
     45–545.15.45.65.9
     55–645.36.76.57.9
     65–745.55.210.99.1
     ≥755.73.813.810.7
     All5.45.45.55.4
    • σ: sd of residuals

    • FEV1: forced expiratory volume in one second

    • FVC: forced vital capacity

    • #: lower limit of normal=eb0+b1A+b2A2+b3ln H

    • coefficient values given in table 2⇑

  • Table 4

    Percentage of population defined as exhibiting lung function below the lower limit of normal (LLN) in “healthy” and whole populations using the Health Survey for England (HSE) and European Coal and Steel Community (ECSC) reference curves by sex and age group#

    Age yrsHSE¶ECSC+
    HealthyWholeHealthyWhole
    FEV1FVCFEV1FVCFEV1FVCFEV1FVC
    Males
     18–244.94.67.47.74.33.05.85.1
     25–345.85.08.87.43.12.65.54.5
     35–446.36.012.58.82.62.66.34.5
     45–543.55.115.110.20.51.68.35.4
     55–643.13.817.712.71.21.512.08.9
     65–707.57.522.817.15.73.818.113.0
     All5.25.213.410.02.62.48.46.2
    Females
     18–244.75.89.77.81.73.35.14.9
     25–344.65.79.17.22.41.94.33.4
     35–446.34.412.59.51.90.95.13.4
     45–545.15.413.810.11.70.75.32.8
     55–645.36.717.513.91.71.28.94.8
     65–704.85.317.813.81.01.09.65.5
     All5.25.512.99.91.91.45.93.9
    • #: range restricted to 18–70 yrs, as recommended for the ECSC prediction equations, to permit comparison

    • FEV1: forced expiratory volume in one second

    • FVC: forced vital capacity

    • ¶: LLN computed from mean lung function=eb0+b1A+b2A2+b3ln H

    • coefficient values given in table 2⇑

    • +: LLN computed from mean – 1.645σ

  • Table 5

    Mean differences and mean differences squared between values observed in the present study and predicted by various prediction equations

    First author [ref.]Age yrsMalesFemales
    Subjects nMean DIFFMean DIFF %Mean squared DIFFSubjects nMean DIFFMean DIFF %Mean squared DIFF
    FEV1
     Present study16–9424790.040.860.2835560.030.870.14
     BrÄndli 118–6020560.000.040.292755−0.01−0.330.15
     Langhammer 1320–802249−0.06−1.560.293249−0.06−2.090.15
     Hankinson 1416–8024590.071.640.2934890.020.690.15
     ECSC 418–7022500.256.010.3531290.206.770.19
    FVC
     Present study16–9424790.040.880.4435560.030.970.23
     BrÄndli 118–602056−0.14−2.770.482755−0.11−3.000.26
     Langhammer 1320–802249−0.05−0.920.463249−0.07−2.060.24
     Hankinson 1416–802459−0.04−0.810.453489−0.04−1.090.24
     ECSC 418–7022500.346.620.5731290.359.730.37
    FEV1/FVC
     Present study16–9424790.00160.190.004335560.00480.570.0042
     Brändli 118–6020560.02252.730.004527550.02102.510.0044
     Langhammer 1320–802249−0.0026−0.320.004532490.00560.680.0044
     Hankinson 1416–8024590.02232.720.004834890.01561.870.0045
     ECSC 418–7022500.01992.430.004631290.02292.740.0046
    • FEV1: forced expiratory volume in one second

    • FVC: forced vital capacity

    • ECSC: European Coal and Steel Community

    • DIFF: difference

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Prediction equations for normal and low lung function from the Health Survey for England
E. Falaschetti, J. Laiho, P. Primatesta, S. Purdon
European Respiratory Journal Mar 2004, 23 (3) 456-463; DOI: 10.1183/09031936.04.00055204

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Prediction equations for normal and low lung function from the Health Survey for England
E. Falaschetti, J. Laiho, P. Primatesta, S. Purdon
European Respiratory Journal Mar 2004, 23 (3) 456-463; DOI: 10.1183/09031936.04.00055204
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