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Cosmed microQuark - Automatic Diagnosis (Algorithm); Quality Control Messages

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Compilation of reference values for lung function measurements in children: Ph. H. Quanjer, J. Stocks, G.Polgar, M. Wise, J. Karlberg, G. Borsboom;
ERJ 1989, 2, Supp.4,184s-261s.
Reference Values for Residual Volume, Functional Residual Capacity and Total Lung Capacity - ATS workshop on Lung Volume measurements,
official statement of the European Respiratory Society; J. Stocks, Ph. H. Quanjer: ERJ, 1995, 8, 492-506
Single Breath Oxygen Test
Buist SA, Ross BB: Quantitative Analysis of the Alveolar Plateau in the Diagnosis of Early Airway Obstruction. ARRD 108: 1081, 1973
Mansell A, Bryan C, Levison H: Airway Closure in Children. JAP 33: 711-714, 1972
Buist SA, Ross BB: Predicted Values for Closing Volumes Using a Modified Single Breath Test. ARRD 107: 744-751, 1973.
Rint
Lombardi E, Sly PD, Concutelli G, et al. Reference values of interrupter respiratory resistance in healthy preschool white children. Thorax 2001; 56:
691-695.
MIP/MEP
Leo F. Black, Robert E. Hyatt: Maximal Respiratory Pressures: Normal Values and Relationship to Age and Sex, American Review of Respiratory
Disease, Volume 99, 1969
Vincken W, Ghezzo H & Cosio MG (1987). Maximal static respiratory pressures in adults: normal values and their relationship to determinants of
respiratory function. Bull Eur Physiopathol Resp 23: 435-439.
Automatic diagnosis (algorithm)
Reference: “Lung Function Testing: selection of reference values and interpretative strategies”, A.R.R.D., 144/ 1991:1202-1218.
LLN=Pred-0.674*SD (ATS, 50° percentile)
LLN=Pred-1.647*SD (ERS, 95° percentile)
LLN=Pred*0.8 (80%Pred)
Message interpretation Criterion
Normal spirometry FVC and FEV1/FVC > LLN
Obstructive abnormality (may be physiological) % Pred FEV1 >= 100
Obstructive abnormality: mild % Pred FEV1 < 100 and >= 70
Obstructive abnormality: moderate % Pred FEV1 < 70 and >= 60
Obstructive abnormality: moderately severe % Pred FEV1 < 60 and >= 50
Obstructive abnormality: severe % Pred FEV1 < 50 and >= 34
Obstructive abnormality: very severe % Pred FEV1 < 34
Restrictive abnormality: mild FVC < LLN and % Pred FVC >= 70
Restrictive abnormality: moderate % Pred FVC < 70 and >= 60
Restrictive abnormality: moderately severe % Pred FVC < 60 and >= 50
Restrictive abnormality: severe % Pred FVC < 50 and >= 34
Restrictive abnormality: very severe % Pred FVC < 34
Quality Control Messages
Reference: Spirometry in the Lung Health Study: Methods and Quality Control, ARRD 1991; 143:1215-1223.
Message Criterion
Start faster VEXT >5% of the FVC and >150ml
Blast out harder PEFT >120 msec
Avoid coughing 50% drop in the flow in first second.
40 - Appendix - Predicted values

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