Introduction and Objectives Spirometry volumes are known to vary with ethnicity (ERJ2012 40(6) 1324–1345), but there are no studies focussing specifically on the variation in spirometry quality seen in children of different ethnicities. Given the importance of spirometry in monitoring lung health, any barriers to providing good quality spirometry should be addressed for optimal management of children with lung disease. Following earlier audit findings, we hypothesised that non-Caucasian children perform spirometry less well than Caucasian children.
Methods Patients with PCD and CF were selected from Royal Brompton Hospital databases using inclusion criteria. From this, retrospective data, which included patient demographics, relevant medical history, and lung function data, were extracted. Categorical data were analysed using Chi-squared test and continuous data were analysed using Mann Whitney-U test. P<0.05 was considered significant.
Results 90 PCD and 29 CF paediatric patients were included for analysis. We found that in the PCD cohort there were more Caucasian children with ≥ 2 (95%) and ≥ 3 (57%) acceptable spirometry manoeuvres compared to non-Caucasian children with ≥ 2 (81%, p<0.01) and ≥ 3 (53%, p<0.01) acceptable spirometry manoeuvres. In the CF cohort, more Caucasian children also had ≥ 2 (100%) and ≥ 3 (80%) acceptable spirometry manoeuvres compared to non-Caucasian children with ≥ 2 (93%) and ≥ 3 (50%, p<0.01) acceptable spirometry manoeuvres. On further analysis, we observed that FEV1 and FVC z-scores, learning difficulties, hearing impairment, interpreter requirement and index of multiple deprivation were not significantly associated with these differences.
Discussion and Conclusion We found that non-Caucasian children had fewer acceptable spirometry manoeuvres compared to Caucasian children, which were not directly explained by the potential causal factors we analysed. However, given the retrospective nature of the study, we were unable to assess several factors including health beliefs and socio-economic factors directly. Although we accept the hypothesis, a further prospective study is needed to determine the reasons behind these observed differences, which could be used to inform and improve future healthcare strategies.
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