What constitutes an obstructive ventilatory impairment in a pediatric population? a comparative study of six definitions by scholarly societies
Bibliographic record
Abstract
Introduction. There is no clear consensus on how to define obstructive ventilatory impairment (OVI) in pediatric populations. Aim. To determine the frequency of OVI among children/adolescents referred for spirometry, using definitions provided by various international respiratory societies. These include the British Columbia (BC), British Thoracic Society _Scottish Intercollegiate Guideline Network (BTS_SIGN 2023), Canadian Thoracic Society (CTS), European Respiratory Society and American Thoracic Society (ERS-ATS), Global Initiative for Asthma (GINA), Irish College of General Practitioners (ICGP), National Asthma Council (NAC), National Institute for Health and Care Excellence (NICE), Société de Pneumologie de Langue Française et de la Société Pédiatrique de Pneumologie et Allergologie (SPLF-SP2A), and South African Thoracic Society (SATS). Methods. This cross-sectional, bi-centric study was conducted at two medical establishments in Sousse, Tunisia, and included children/adolescents aged 6 to 18 years. Participants completed a medical questionnaire, and clinical and anthropometric data were collected. Spirometric measurements were performed using two spirometers. Some participants also underwent skin prick tests if recommended by their physicians. OVI was assessed using six definitions: i) GINA: Forced expiratory volume in one second (FEV1) < 80% and a FEV1/forced vital capacity (FVC) ≤ 0.90; ii) ICGP: FEV1/FVC < 0.70; iii) ERS-ATS or BTS_SIGN 2023 or SATS or SPLF-SP2A or NAC: FEV1/FVC z-score < -1.645; iv) NICE: FEV1/FVC < 0.70 or FEV1/FVC z-score < -1.645; v) CTS: FEV1/FVC < 0.80 or a FEV1/FVC z-score < -1.645; and vi) ERS: “FEV1 z-score or FEV1/FVC z-score” < -1.645 or “FEV1 or FEV1/FVC” < 0.80. Results. The frequency of OVI varied significantly depending on the definition applied: GINA (24.9%), ICGP (7.6%), ERS-ATS (19.3%), NICE (27.9%), CTS (37.5%), and ERS (37.5%). OVI was significantly associated with male sex, allergies, and asthma. There were also notable differences in FEV1, FVC, and FEV1/FVC values across the different definitions. Conclusion. The rate of OVI in pediatric populations varies considerably based on the diagnostic criteria used. Male sex, allergies, and asthma are significantly associated with the presence of OVI.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.006 | 0.012 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.004 | 0.004 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".