Resumen
Objective To evaluate several alternative measures of forced expiratory volume in 1 second percent predicted (FEV 1 %pred) variability as potential predictors of future FEV 1 %pred decline in patients with cystic fibrosis. Study design We included 13 827 patients age ≥6 years from the Epidemiologic Study of Cystic Fibrosis 1994-2002 with ≥4 FEV 1 %pred measurements spanning ≥366 days in both a 2-year baseline period and a 2-year follow-up period. We predicted change from best baseline FEV 1 %pred to best follow-up FEV 1 %pred and change from baseline to best in the second follow-up year by using multivariable regression stratified by 4 lung-disease stages. We assessed 5 measures of variability (some as deviations from the best and some as deviations from the trend line) both alone and after controlling for demographic and clinical factors and for the slope and level of FEV 1 %pred. Results All 5 measures of FEV 1 %pred variability were predictive, but the strongest predictor was median deviation from the best FEV 1 %pred in the baseline period. The contribution to explanatory power (R 2 ) was substantial and exceeded the total contribution of all other factors excluding the FEV 1 %pred rate of decline. Adding the other variability measures provided minimal additional value. Conclusions Median deviation from the best FEV 1 %pred is a simple metric that markedly improves prediction of FEV 1 %pred decline even after the inclusion of demographic and clinical characteristics and the FEV 1 %pred rate of decline. The routine calculation of this variability measure could allow clinicians to better identify patients at risk and therefore in need of increased intervention.
| Idioma original | English (US) |
|---|---|
| Páginas (desde-hasta) | 116-121.e2 |
| Publicación | Journal of Pediatrics |
| Volumen | 169 |
| DOI | |
| Estado | Published - may 1 2016 |
ASJC Scopus subject areas
- Pediatrics, Perinatology, and Child Health
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En: Journal of Pediatrics, Vol. 169, 01.05.2016, p. 116-121.e2.
Resultado de la investigación: Article › revisión exhaustiva
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TY - JOUR
T1 - Forced Expiratory Volume in 1 Second Variability Helps Identify Patients with Cystic Fibrosis at Risk of Greater Loss of Lung Function
AU - Morgan, Wayne J.
AU - Vandevanter, Donald R.
AU - Pasta, David J.
AU - Foreman, Aimee J.
AU - Wagener, Jeffrey S.
AU - Konstan, Michael W.
AU - Liou, Ted
AU - McColley, Susanna
AU - McMullen, Ann
AU - Quittner, Alexandra
AU - Regelmann, Warren
AU - Ren, Clement
AU - Rosenfeld, Margaret
AU - Sawicki, Greg
AU - Schechter, Michael
AU - Woo, Marlyn
AU - Brasfield, Dana
AU - Lyrene, Raymond
AU - Sindel, Lawrence
AU - Roberts, Dion
AU - Carroll, John
AU - Warren, Robert
AU - Nassri, Louay
AU - Anderson, Paula
AU - Brown, Mark
AU - Silverthorn, Amy
AU - Radford, Peggy
AU - Gong, Gerald
AU - Legris, Gregory
AU - Greene, Gerald
AU - Sudhakar, Reddivalam
AU - Platzker, Arnold
AU - Nickerson, Bruce
AU - Hardy, Karen
AU - Harwood, Ivan
AU - Shay, Gregory
AU - Quick, Bryon
AU - Lieberthal, Allan
AU - Moss, Richard
AU - Landon, Chris
AU - Fanous, Yvonne
AU - Lieberman, Jay
AU - Spiritus, Eugene
AU - Chipps, Bradley
AU - McDonald, Ruth
AU - Pian, Mark
AU - Cropp, Gerd
AU - Lewis, Nancy
AU - Nielson, Dennis
AU - Shapiro, Bertrand
AU - Accurso, Frank
AU - Saavedra, Milene
AU - Daigle, Karen
AU - Hen, Jacob
AU - Palazzo, Regina
AU - Dodds, Kathryn
AU - Pad-Man, Raj
AU - Goodill, John
AU - Winnie, Glenna
AU - Davies, Lea
AU - Kriseman, Tony
AU - Sallent, Jorge
AU - Chiaro, Joseph
AU - Kubiet, Martin
AU - Goldfinger, Sue
AU - Schwartzman, Morton
AU - Diaz, Carlosenrique
AU - Maupin, Kevin
AU - Riff, Eduardo
AU - Geller, David
AU - Livingston, Floyd
AU - Mavunda, Kunjana
AU - Birriel, Jose
AU - Faverio, Luis
AU - Rosenberg, David
AU - Schaeffer, David
AU - Sherman, James
AU - Wagner, Mary
AU - Light, Michael
AU - Schnapf, Bruce
AU - Montgomery, Gary
AU - Kirchner, Kevin
AU - Weatherly, Mark
AU - Caplan, Daniel
AU - Guill, Margaret
AU - Hudson, Valera
AU - Akhter, Javeed
AU - Davison, Donald
AU - Boas, Steven
AU - Chung, Youngran
AU - Latner, Rennee
AU - Aljadeff, Gabriel
AU - Chan, Youngran
AU - Kraut, Jerome
AU - Stone, Arvey
AU - Still, John Lloyd
AU - Sharma, Girish
AU - Eagleton, Lanie
AU - Hopkins, Patricia
AU - Chatrath, Umesh
AU - Lester, Lucille
AU - Kim, Young Jee
AU - Anthony, Veena
AU - Eigan, Howard
AU - Howenstine, Michelle
AU - James, Pushpom
AU - Gergesha, Edward
AU - Harris, James
AU - Plant, Robert
AU - Zivkovich, Veljko
AU - Collins, Angela
AU - Nassif, Edward
AU - Ahrens, Richard
AU - Doornbos, Daniel
AU - Kanarek, Joseph
AU - Leff, Richard
AU - Shaw, Pamela
AU - Demoss, Elanor
AU - Riva, Maria
AU - Sullivan, Leonard
AU - Anstead, Michael
AU - Kanga, Jamshed
AU - Eid, Nemr
AU - Morton, Ron
AU - Hilman, Bettina
AU - Jones, Kim
AU - Davis, Scott
AU - Harder, Ralph
AU - Lever, Tom
AU - Cairns, Anne Marie
AU - Caldwell, Edgar
AU - Zuckerman, Jonathan
AU - Mogayzel, Peter
AU - Rosenstein, Beryl
AU - McQuestion, John
AU - Perry, Donna
AU - Rosenberg, Samuel
AU - Gerstle, Robert
AU - Colin, Andrew
AU - Wohl, Mary Ellen
AU - Lapey, Allan
AU - Yee, William
AU - O'Sullivan, Brian
AU - Zwerdling, Robert
AU - Abdulhamid, Ibrahim
AU - O'Hagan, Adrian
AU - Schuen, John
AU - Kurlandsky, Lawrence
AU - Honicky, Richard
AU - Homnick, Douglas
AU - Marks, John
AU - Pichurko, Bohdan
AU - Maxvold, Norma
AU - Nasr, Samya
AU - Simon, Richard
AU - Tsai, Wan
AU - Kissner, Dana
AU - McNamara, John
AU - Henry, Nancy
AU - Marker, Stephen
AU - Pryor, Michael
AU - Walker, Lynn
AU - Woodward, Jim
AU - Mizell, Louis
AU - Miller, Suzanne
AU - Rosenbluth, Daniel
AU - Black, Philip
AU - McCubbin, Michael
AU - Cohen, Alan
AU - Ferkol, Thomas
AU - Mallory, George
AU - Rejent, Anthony
AU - Rubin, Bruce
AU - Graff, Gavin
AU - Konig, Peter
AU - Colombo, John
AU - Murphy, Peter
AU - Boyle, William
AU - Parker, Worth
AU - Patton, Chandler
AU - Zanni, Robert
AU - Atlas, Arthur
AU - Turcios, Nelson
AU - Laraya-Cuasay, Lourdes
AU - Bisberg, Dorothy
AU - Aguila, Helen
AU - Allen, Sarah
AU - James, David
AU - Perkett, Elizabeth
AU - Thompson, Marsha
AU - Budhecha, Sonia
AU - Diaz, Ruben
AU - Rosen, Jonathan
AU - Kaslovsky, Robert
AU - Percciacante, Ronald
AU - Borowitz, Drucy
AU - Cronin, Joseph
AU - McMahon, Colin
AU - Quittell, Lynne
AU - Giusti, Robert
AU - Cohen, Rubin
AU - Decelie-Germana, Joan
AU - Gorvoy, Jack
AU - Patel, Kalpan
AU - Kattan, Meyer
AU - Dozor, Allen
AU - Dimango, Emily
AU - Berdella, Maria
AU - Anbar, Ran
AU - Ianuzzi, Debra
AU - Sexton, James
AU - Tayag-Kier, Catherine
AU - McBride, John
AU - Voter, Karen
AU - Dimaio, Mary
AU - Georgitis, John
AU - Majure, Joseph Marc
AU - Martinez, Maria
AU - McIntosh, Clarke
AU - Leigh, Margaret
AU - Black, Hugh
AU - Hughes, James
AU - Kantak, Anand
AU - Wilmott, Robert
AU - Omlor, Gregory
AU - Stone, Robert
AU - McCoy, Karen
AU - Acton, James
AU - Doershuk, Carl
AU - Fink, Robert
AU - Steffan, Michael
AU - Vauthy, Pierre
AU - Joseph, Patricia
AU - Reyes, Santiago
AU - Kramer, John
AU - Royall, James
AU - Eisenberg, Jay
AU - Wall, Michael
AU - Fiel, Stanley
AU - Scanlin, Thomas
AU - Phadke, Shroti
AU - Weinberg, Joel
AU - Sexauer, William
AU - Wolf, Stephen
AU - Holsclaw, Douglas
AU - Klein, Debra
AU - Warren, Stuart
AU - Kinsey, Robert
AU - Perez, Carlos
AU - Ganeshanathan, Muttiah
AU - Shinnick, James
AU - Panitch, Howard
AU - Varlotta, Laurie
AU - Robinson, Cynthia
AU - Santana, Jose Rodriguez
AU - Passero, Mary Ann
AU - Gwinn, Jane
AU - Baker, Robert
AU - Bowman, Michael
AU - Flume, Patrick
AU - Brown, Daniel
AU - Marville, Roxanne
AU - Wallace, James
AU - Parry, Rodney
AU - Ellenburg, Don
AU - Rogers, John
AU - Mohon, Ricky
AU - Ledbetter, Joel
AU - Hanissian, Aram
AU - Schoumacher, Robert
AU - Campbell, Preston
AU - Harris, Christopher
AU - Slovis, Bonnie
AU - Stokes, Dennis
AU - Hale, Kathryn
AU - Katz, Marcia
AU - Seilheimer, Dan
AU - Sockrider, Marianne
AU - Frank, Allan
AU - Daniel, James
AU - Cunningham, James
AU - Browning, Iley
AU - Bray, John
AU - Dove, Amanda
AU - Mandujano, Fernando
AU - Tremper, Larry
AU - Morse, Martha
AU - Willey-Courand, Donna
AU - Copenhaver, Steven
AU - Pohl, John
AU - McWilliams, Bennie
AU - Martine-Logvinoff, Marie
AU - Wallace, Marsh
AU - Klein, Robert
AU - Amaro, Rodolfo
AU - Couch, Leslie
AU - Brown, Michael
AU - Prestidge, Claude
AU - Inscore, Stephen
AU - Lipton, Andrew
AU - Chatfield, Barbara
AU - Marshall, Bruce
AU - Lahiri, Thomas
AU - Swartz, Donald
AU - Whittaker, Laurie
AU - Karlson, Karl
AU - Ropoll, Ignacio
AU - Rubio, Thomas
AU - Schmidt, Joel
AU - Thomas, David
AU - Osborn, John
AU - Froh, Deborah
AU - Gaston, Benjamin
AU - Elliott, Greg
AU - Gibson, Ronald
AU - Ramsey, Bonnie
AU - McCarthy, Michael
AU - Larson, Lawrence
AU - Ricker, David
AU - Robbins, Mark
AU - Aitken, Moira
AU - Emerson, Julia
AU - Aronoff, Stephen
AU - Moffett, Kathryn
AU - Biller, Julie
AU - Splaingard, Mark
AU - Sullivan, Bradley
AU - Pritchard, Paul
AU - Adair, Stu
AU - Holzwarth, Peter
AU - Dopico, Guillermo
AU - Meyer, Keith
AU - Green, Christopher
AU - Rock, Michael
N1 - Funding Information: The Epidemiologic Study of Cystic Fibrosis was supported by Genentech, Inc (San Francisco, CA). W.M., D.VanD., J.W., and M.K. received honoraria from Genentech for serving as members of the Scientific Advisory Group for the Epidemiologic Study of Cystic Fibrosis and have served as consultants to Genentech. D.P. and A.F. are employees of ICON Clinical Research, which was paid by Genentech for providing analytical services for this study. J.W. was previously an employee of Genentech. Publisher Copyright: © 2016 Elsevier Inc.
PY - 2016/5/1
Y1 - 2016/5/1
N2 - Objective To evaluate several alternative measures of forced expiratory volume in 1 second percent predicted (FEV 1 %pred) variability as potential predictors of future FEV 1 %pred decline in patients with cystic fibrosis. Study design We included 13 827 patients age ≥6 years from the Epidemiologic Study of Cystic Fibrosis 1994-2002 with ≥4 FEV 1 %pred measurements spanning ≥366 days in both a 2-year baseline period and a 2-year follow-up period. We predicted change from best baseline FEV 1 %pred to best follow-up FEV 1 %pred and change from baseline to best in the second follow-up year by using multivariable regression stratified by 4 lung-disease stages. We assessed 5 measures of variability (some as deviations from the best and some as deviations from the trend line) both alone and after controlling for demographic and clinical factors and for the slope and level of FEV 1 %pred. Results All 5 measures of FEV 1 %pred variability were predictive, but the strongest predictor was median deviation from the best FEV 1 %pred in the baseline period. The contribution to explanatory power (R 2 ) was substantial and exceeded the total contribution of all other factors excluding the FEV 1 %pred rate of decline. Adding the other variability measures provided minimal additional value. Conclusions Median deviation from the best FEV 1 %pred is a simple metric that markedly improves prediction of FEV 1 %pred decline even after the inclusion of demographic and clinical characteristics and the FEV 1 %pred rate of decline. The routine calculation of this variability measure could allow clinicians to better identify patients at risk and therefore in need of increased intervention.
AB - Objective To evaluate several alternative measures of forced expiratory volume in 1 second percent predicted (FEV 1 %pred) variability as potential predictors of future FEV 1 %pred decline in patients with cystic fibrosis. Study design We included 13 827 patients age ≥6 years from the Epidemiologic Study of Cystic Fibrosis 1994-2002 with ≥4 FEV 1 %pred measurements spanning ≥366 days in both a 2-year baseline period and a 2-year follow-up period. We predicted change from best baseline FEV 1 %pred to best follow-up FEV 1 %pred and change from baseline to best in the second follow-up year by using multivariable regression stratified by 4 lung-disease stages. We assessed 5 measures of variability (some as deviations from the best and some as deviations from the trend line) both alone and after controlling for demographic and clinical factors and for the slope and level of FEV 1 %pred. Results All 5 measures of FEV 1 %pred variability were predictive, but the strongest predictor was median deviation from the best FEV 1 %pred in the baseline period. The contribution to explanatory power (R 2 ) was substantial and exceeded the total contribution of all other factors excluding the FEV 1 %pred rate of decline. Adding the other variability measures provided minimal additional value. Conclusions Median deviation from the best FEV 1 %pred is a simple metric that markedly improves prediction of FEV 1 %pred decline even after the inclusion of demographic and clinical characteristics and the FEV 1 %pred rate of decline. The routine calculation of this variability measure could allow clinicians to better identify patients at risk and therefore in need of increased intervention.
KW - %pred Percent predicted
KW - CF Cystic fibrosis
KW - FEV Forced expiratory volume in 1 second
UR - http://www.scopus.com/inward/record.url?scp=84959338703&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84959338703&partnerID=8YFLogxK
U2 - 10.1016/j.jpeds.2015.08.042
DO - 10.1016/j.jpeds.2015.08.042
M3 - Article
C2 - 26388208
AN - SCOPUS:84959338703
SN - 0022-3476
VL - 169
SP - 116-121.e2
JO - Journal of Pediatrics
JF - Journal of Pediatrics
ER -