Lisätietoa aiheesta

LLN (lower limit of normal)

Lisätietoa aiheesta
21.11.2019
Käypä hoito -työryhmä Keuhkoahtaumatauti

Määritelmä FEV1/FVC < 0,7 aiheuttaa viitearvoon perustuvaan LLN (lower limit of normal) -määritelmään verrattuna jonkin verran ylidiagnostiikkaa iäkkäillä «Kainu A, Timonen K, Lindqvist A ym. GOLD criteria overestimate airflow limitation in one-third of cases in the general Finnish population. ERJ Open Res 2016;2: »1, «Schermer TR, Smeele IJ, Thoonen BP ym. Current clinical guideline definitions of airflow obstruction and COPD overdiagnosis in primary care. Eur Respir J 2008;32:945-52 »2, «Vollmer WM, Gíslason T, Burney P ym. Comparison of spirometry criteria for the diagnosis of COPD: results from the BOLD study. Eur Respir J 2009;34:588-97 »3 ja mahdollisesti naisilla «Jordan RE, Miller MR, Lam KB ym. Sex, susceptibility to smoking and chronic obstructive pulmonary disease: the effect of different diagnostic criteria. Analysis of the Health Survey for England. Thora»4 sekä alidiagnostiikkaa alle 45-vuotiailla «Vollmer WM, Gíslason T, Burney P ym. Comparison of spirometry criteria for the diagnosis of COPD: results from the BOLD study. Eur Respir J 2009;34:588-97 »3, mutta se on herkkä lääkärin kliinisesti varmistaman keuhkoahtaumataudin toteamisessa «Güder G, Brenner S, Angermann CE ym. "GOLD or lower limit of normal definition? A comparison with expert-based diagnosis of chronic obstructive pulmonary disease in a prospective cohort-study". Respir»5, «Mohamed Hoesein FA, Zanen P, Sachs AP ym. Spirometric thresholds for diagnosing COPD: 0.70 or LLN, pre- or post-dilator values? COPD 2012;9:338-43 »6, «Mohamed Hoesein FA, Zanen P, Lammers JW. Lower limit of normal or FEV1/FVC < 0.70 in diagnosing COPD: an evidence-based review. Respir Med 2011;105:907-15 »7. Määritelmän mukainen ahtauman aste on verrannollinen kuolleisuuteen «Mannino DM, Diaz-Guzman E. Interpreting lung function data using 80% predicted and fixed thresholds identifies patients at increased risk of mortality. Chest 2012;141:73-80 »8.

Kirjallisuutta

  1. Kainu A, Timonen K, Lindqvist A ym. GOLD criteria overestimate airflow limitation in one-third of cases in the general Finnish population. ERJ Open Res 2016;2: «PMID: 28053971»PubMed
  2. Schermer TR, Smeele IJ, Thoonen BP ym. Current clinical guideline definitions of airflow obstruction and COPD overdiagnosis in primary care. Eur Respir J 2008;32:945-52 «PMID: 18550607»PubMed
  3. Vollmer WM, Gíslason T, Burney P ym. Comparison of spirometry criteria for the diagnosis of COPD: results from the BOLD study. Eur Respir J 2009;34:588-97 «PMID: 19460786»PubMed
  4. Jordan RE, Miller MR, Lam KB ym. Sex, susceptibility to smoking and chronic obstructive pulmonary disease: the effect of different diagnostic criteria. Analysis of the Health Survey for England. Thorax 2012;67:600-5 «PMID: 22382600»PubMed
  5. Güder G, Brenner S, Angermann CE ym. "GOLD or lower limit of normal definition? A comparison with expert-based diagnosis of chronic obstructive pulmonary disease in a prospective cohort-study". Respir Res 2012;13:13 «PMID: 22309369»PubMed
  6. Mohamed Hoesein FA, Zanen P, Sachs AP ym. Spirometric thresholds for diagnosing COPD: 0.70 or LLN, pre- or post-dilator values? COPD 2012;9:338-43 «PMID: 22489910»PubMed
  7. Mohamed Hoesein FA, Zanen P, Lammers JW. Lower limit of normal or FEV1/FVC < 0.70 in diagnosing COPD: an evidence-based review. Respir Med 2011;105:907-15 «PMID: 21295958»PubMed
  8. Mannino DM, Diaz-Guzman E. Interpreting lung function data using 80% predicted and fixed thresholds identifies patients at increased risk of mortality. Chest 2012;141:73-80 «PMID: 21659434»PubMed