ABSTRACT
Tunisian pulmonary functional laboratories accept the default settings for reference equations [European Respiratory Society/European Community for Steel and Coal [ERS/ECSC1983] offered by the manufacturer even though adult Tunisian reference equations [Tunisian1995] are available. To compare the spirometric profile of Tunisian subjects, according to the two reference equations. Spirometric data were recorded from 1192 consecutive spirometry procedures in adults aged 18-60 years. Reference values and lower limits of normality [LLN] were calculated using the two reference equations. Applied definitions: large airway obstructive ventilatory defect [LAOVD]: ratio between the 1st second expiratory volume and forced vital capacity [FEV1/FVC] < LLN. Small AOVD [SAOVD]: FEV1/FVC > LLN and FVC > LLN and maximal midexpiratory flow < LLN. Tendency through a restrictive ventilatory defect [TRVD]: FEV1 and FVC < LLN. The spirometric profile, according the two reference equations, was determined. Using Tunisian1995 reference equations, 34%, 7%, 37% and 19% of spirometry records were interpreted as normal, and as having, LAOVD, SAOVD and TRVD, respectively. Using ERS/ECSC1983 reference equations, 85%, 3%, 9% and 2% of spirometry records were interpreted as normal, and as having, LAOVD, SAOVD and TRVD, respectively. Using the ERS/ECSC1983 reference equations, misclassification was worse for LAOVD, for SAOVD and for TRVD, respectively, 68%, 94% and 89%. Our results showed that the use of the old Caucasian reference equations resulted in misinterpretation of spirometry data in a significant proportion of subjects. This could result in inappropriate diagnosis and/or management