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Lung Function Reference Equations for Indian Ethnic Groups Based on a Handheld Forced Oscillation Device for Age 9–19 Years

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Abstract

Objective

To develop regression equations to predict forced oscillation technique (FOT) parameters in Indian children and adolescents.

Methods

Lung function was assessed in a multigeographic cohort of residential school children using a portable FOT-based device (PulmoScan) and spirometry. FOT measurements were performed in 1497 study participants, aged 9–19 y, from 8 Indian districts. Bland–Altman analysis was performed for additional 32 adult subjects to compare the results of PulmoScan to a standard IOS device in an outpatient setting. Reference equations were developed for Rrs and Xrs from the data of healthy subjects with normal spirometry using multivariate regression model for Indo-European, Dravidian, and mixed ethnic groups.

Results

X5 (bias = 0.02) showed a better agreement than resistance parameters (R5 bias = 0.75, R20 bias =  −0.22) in IOS/PulmoScan comparison. Anthropometric variables (age, height, and weight) were positively correlated with reactance (X5) and negatively with resistance parameters (R5, R10, R15, and R20), with most associations being stronger in boys. Final regression model considered ethnicity as a key determinant along with anthropometry.

Conclusion

Multiethnic reference equations were developed for Indian children aged 9–19 y based on a novel handheld FOT device.

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Data Availability

Deidentified categorized data of the participants can be provided on request basis after approval of ethics committee of the institute/organization to which the requesting person belongs, stating the potential need and usage and signing of an agreement with the corresponding authors on behalf of CSIR-IGIB. The request could be made to the corresponding authors after 90 d of publication and the final data used for developing equations will be provided on as it is basis after deanonymization.

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Acknowledgements

MA would like to acknowledge CSIR for fellowship. AA and VS would like to acknowledge Wellcome Trust DBT India Alliance IA/CPHS/ 14/1/501489, Indo-US S&T Forum grant USISTEF/HI-011/2015-16 and CSIR MLP 5502 for support of this work. MA, AA and VS would like to acknowledge Anubhuti Bansal and Shailendra for their contribution in data collection.

Funding

Wellcome Trust, CSIR and USISTEF. The sponsor of this study had no role in study design, data collection, data analysis, data interpretation, or writing of this report.

Author information

Authors and Affiliations

  1. CSIR-Institute of Genomics and Integrative Biology, New Delhi, 110007, India

    Mohit Aggarwal, Anurag Agrawal & Viren Sardana

  2. CSIR-Central Scientific Instruments Organization, Chandigarh, India

    Neerja Mittal Garg

  3. Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, Uttar Pradesh, India

    Mohit Aggarwal, Neerja Mittal Garg, Anurag Agrawal & Viren Sardana

Authors
  1. Mohit Aggarwal
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  2. Neerja Mittal Garg
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  3. Anurag Agrawal
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  4. Viren Sardana
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Contributions

AA and VS conceived the objectives; MA collected the data; MA, VS, AA, and NMG did the primary analysis; VS and MA wrote the first draft; AA and NMG reviewed and edited the manuscript. AA will act as the guarantor for this paper.

Corresponding authors

Correspondence to Anurag Agrawal or Viren Sardana.

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Ethics Approval

The study protocol was approved by the institutional human ethics committee of CSIR-IGIB, New Delhi.

Conflict of Interest

MA, NM and VS declare no conflict of interest. AA is a part of the development team of Pulmoscan.

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Aggarwal, M., Garg, N.M., Agrawal, A. et al. Lung Function Reference Equations for Indian Ethnic Groups Based on a Handheld Forced Oscillation Device for Age 9–19 Years. Indian J Pediatr 90, 61–68 (2023). https://doi.org/10.1007/s12098-022-04176-2

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  • DOI: https://doi.org/10.1007/s12098-022-04176-2

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