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To interpret ventilatory function tests in
any individual, compare the results with reference values
obtained from a well-defined population of normal subjects
matched for sex, age, height and ethnic origin and using
similar test protocols; and carefully calibrated and
validated instruments.1
Normal predicted values for ventilatory
function generally vary as follows:
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1. |
Sex: |
For a given height and age, males have a larger FEV1,
FVC, FEF25-75% and PEF, but a slightly lower FEV1/FVC. |
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2. |
Age: |
FEV1, FVC, FEF25-75%
and PEF increase, while FEV1/FVC
decreases, with age until about 20 years old in
females and 25 years in males.
After this, all indices gradually fall,
although the precise rate of decline is probably
masked due to the complex interrelationship
between age and height. The fall in FEV1/FVC
with age in adults is due to the greater decline
in FEV1 than FVC. |
|
3. |
Height: |
All indices other than FEV1/FVC
increase with standing height. |
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4. |
Ethnic Origin: |
Caucasians have the largest FEV1
and FVC and, of the various ethnic
groups, Polynesians are among the
lowest. The values for black Africans
are 10-15% lower than for Caucasians of
similar age, sex and height because for
a given standing height their thorax is
shorter; normal values for Indigenous
Australians may be even lower. Chinese have been found to have
an FVC about 20% lower and Indians about
10% lower than matched Caucasians. There
is little difference in PEF between
ethnic groups. |
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There is a vast literature
of normal population studies, many of which
have deficiencies in sample size, definition
of normality, inclusion of smokers and
choice of equipment.
Appendix B
provides tables of mean predicted values
from a well-conducted study on a US
Caucasian population2.
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