Background

The Gulf Long-Term Follow-up (GuLF) Study is a prospective cohort study of health effects associated with oil spill response and clean-up following the 2010 Deepwater Horizon Disaster (DWH). As part of the study, spirometry testing of lung function was carried out in home visits across multiple states. Few studies have described factors associated with spirometry test failure in field-based settings.

Objective

Our objective was to identify what factors, if any, predict test failure among GuLF Study participants who completed spirometry testing in a non-traditional setting.

Methods

Trained examiners administered spirometry (May 2011–May 2013) to 10,019 participants living in US Gulf States (LA, MS, TX, AL, FL) using an Easy-on ultrasonic spirometer. We applied American Thoracic Society/European Respiratory Society quality criteria to determine quality test failure and identified factors predictive of failure using both a Stepwise and a LASSO model. We calculated odds ratios and 95% confidence intervals (CIs) for associations of selected factors with test failure.

Results

Among GuLF Study participants who conducted spirometry, self-reported African American/Black participants (OR: 1.39, 95% CI: 1.23,1.56); men (OR:1.61, 95% CI: 1.41,1.83); and those making less than $20,000 per year (OR: 1.45, 95% CI: 1.26,1.67) were more likely to fail quality testing, while those who were obese were less likely to fail (OR: 0.61, 95% CI: 0.42,0.89).

Conclusion

Field-based studies involving spirometry should identify and account for participant factors that may influence test failure. Coaching that is tailored to those less likely to have experience with spirometry may help reduce test failure rates.

中文翻译：

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大型多态前瞻性研究中的肺活量质量预测因子

背景

海湾长期随访 (GuLF) 研究是一项前瞻性队列研究，研究与 2010 年深水地平线灾难(DWH) 后溢油响应和清理相关的健康影响。作为研究的一部分，在多个州的家访中进行了肺功能的肺活量测定。很少有研究描述了在现场环境中与肺活量测试失败相关的因素。

客观的

我们的目标是确定哪些因素（如果有）可以预测在非传统环境中完成肺活量测定的 GuLF 研究参与者的测试失败。

方法

训练有素的检查员使用 Easy-on 超声波肺活量计对居住在美国海湾国家（洛杉矶、密西西比州、德克萨斯州、阿拉巴马州、佛罗里达州）的 10,019 名参与者进行肺活量测定（2011 年 5 月至 2013 年 5 月）。我们应用美国胸科学会/欧洲呼吸学会质量标准来确定质量测试失败，并使用逐步和 LASSO 模型确定了预测失败的因素。我们计算了选定因素与测试失败关联的优势比和 95% 置信区间 (CI)。

结果

在进行肺活量测定的 GuLF 研究参与者中，自我报告的非裔美国人/黑人参与者（OR：1.39，95% CI：1.23,1.56）；男性（OR：1.61，95% CI：1.41，1.83）；年收入低于 20,000 美元的人 (OR: 1.45, 95% CI: 1.26,1.67) 质量测试失败的可能性更大，而肥胖的人失败的可能性较小 (OR: 0.61, 95% CI: 0.42, 0.89）。

结论

涉及肺活量测定的实地研究应确定并考虑可能影响测试失败的参与者因素。为那些不太可能有肺活量测定经验的人量身定制的指导可能有助于降低测试失败率。