Tuberc Respir Dis > Volume 64(2); 2008 > Article
Tuberculosis and Respiratory Diseases 2008;64(2):80-86.
DOI: https://doi.org/10.4046/trd.2008.64.2.80    Published online February 1, 2008.
Clinical Usefulness and the Accuracy of Korean Reference Equation for Diffusing Capacity.
Seung Won Ra, Tai Sun Park, Yoonki Hong, Sang Bum Hong, Tae Sun Shim, Chae Man Lim, Sang Do Lee, Younsuck Koh, Woo Sung Kim, Dong Soon Kim, Won Dong Kim, Yeon Mok Oh
1Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. ymoh55@amc.seoul.kr
2Clinical Research Center for Chronic Obstructive Airway Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Abstract
BACKGROUND
Park et al. developed the Korean reference equation for the measurement of diffusing capacity in 1985. However, the equation has not been widely used in Korea and foreign reference equations have been popularly used. We intended to compare the clinical usefulness and the accuracy of the the Korean reference equation (Park's equation) with that of the foreign equation (Burrows' equation) that is commonly used in Korea. METHODS: 1. Evaluation of clinical usefulness; Among 1,584 patients who underwent diffusing capacity (D(L)CO) at the Asan Medical Center from July to December 2006, group A subjects included 276 patients who had different interpretations of D(L)CO in trials employing Burrows' equation and Park's equation. Clinical assessment was decided by consensus of two respiratory physicians. In order to evaluate the clinical usefulness of Burrows' equation and Park's equation, agreement of clinical assessment and DLCO interpretation were measured. 2. Evaluation of accuracy; Group B subjects were 81 patients with interstitial lung disease (ILD) and 39 normal subjects. The 81 ILD patients were diagnosed following a surgical lung biopsy. The accuracy of diagnosing ILD as well as sensitivity and specificity were evaluated according to the use of the reference equations (Burrows' equation and Park's equation) for DLCO. RESULTS: Agreement between clinical assessment and interpretation of D(L)CO was 22% for the use of Burrows' equation and 78% for the use of Park's equation. The sensitivity and specificity of the Burrows' equation for diagnosing ILD were 64.2% and 100%. The sensitivity and specificity of the Park's equation for diagnosing ILD were 90.1% and 100%. The sensitivity of the Park's equation for diagnosing ILD was significantly higher than that of Burrows' equation (p<0.001). CONCLUSION: The Korean reference equation (Park's equation) was more clinically useful and had higher sensitivity for diagnosing ILD than the foreign reference equation (Burrows' equation).
Key Words: Diffusing capacity, Reference equations, Clinical usefulness, Accuracy


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