Background: Total lung capacity (TLC) measured with single-breath gas diffusion (TLCsb) is systematically lower than TLC measured with whole-body plethysmography (TLCwbp) especially in patients with obstructive defects. We aimed to develop and validate a regression correction equation to reduce the discrepancy between the two measurements of TLC. Second, we compared the ability to detect restriction (reduced TLC) from adjusted TLC measured by single-breath (TLCsb) with gold standard TLCwbp.
Methods: Lung function data from 800 consecutive patients were analysed with multivariable linear regression. A group of 530 were included for model development, and 270 were used for model validation.
Results: TLCsb was found to be on average 1.1 L lower than TLCwbp ( < 0.001). This difference increased with degree of airway obstruction. After adjustment TLCsb did not significantly differ from TLCwbp in obstructive and mixed obstructive-restrictive subjects. TLCsb had a sensitivity of 70% and a specificity of 99% to predict restriction on an individual basis, with a 95% confidence interval (CI) of [-19.6%; 17.7%] percentage when comparing adjusted values of TLCsb with the true TLCwbp value.
Conclusions: After adjustment TLCsb was no longer significantly underestimated in obstructive and mixed restrictive-obstructive groups compared to TLCwbp. The adjustment can be used on individual subjects to estimate restriction via the TLCsb, thereby making the single-breath gas diffusion method a more valid alternative than without adjustment, when compared with the gold standard whole-body plethysmography to measure TLC.
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| http://dx.doi.org/10.1080/20018525.2025.2470002 | DOI Listing |
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