Lung clearance index in adults and children with cystic fibrosis

Katherine O'Neill, Michael M. Tunney, Elinor Johnston, Stephen Rowan, Damian G. Downey, Jacqueline Rendall, Alastair Reid, Ian Bradbury, J. Stuart Elborn, Judy M. Bradley

Research output: Contribution to journalArticlepeer-review

35 Citations (Scopus)
642 Downloads (Pure)

Abstract

Background: Lung clearance index (LCI) has good clinimetric properties and an acceptable feasibility profile as a surrogate endpoint in Cystic Fibrosis (CF). Although most studies to date have been in children, increasing numbers of adults with CF also have normal spirometry. Further study of LCI as an endpoint in CF adults is required. Therefore, the purpose of this study was to determine the clinimetric properties of LCI over the complete age range of people with CF.Methods: Clinically stable adults and children with CF and age matched healthy controls were recruited.Results: LCI and spirometry data for 110 CF subjects and 61 controls were collected at a stable visit. CF Questionnaire-Revised (CFQ-R) was completed by 80/110 CF subjects. Fifty-six CF subjects completed a second stable visit. The LCI CV% was 4.1% in adults and 6.3% in children with CF. The coefficient of repeatability of LCI was 1.2 in adults and 1.3 in children. In both adults and children, LCI (AUCROC=0.93 and 0.84) had greater combined sensitivity and specificity to discriminate between people with CF and controls compared to FEV1 (AUCROC=0.88 and 0.60) and FEF25-75 (AUCROC=0.87 and 0.68). LCI correlated significantly with the CFQ-R treatment burden in adults (r=-0.37; p<0.01) and children (r=-0.50; p<0.01). Washout tests were successful in 90% of CF subjects and were perceived as comfortable and easy to perform in both adults and children.Conclusions: These data support the use of LCI as a surrogate outcome measure in CF clinical trials in adults as well as children.
Original languageEnglish
Pages (from-to)1323-1332
Number of pages10
JournalChest
Volume150
Issue number6
Early online date06 Jul 2016
DOIs
Publication statusEarly online date - 06 Jul 2016

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