Forced Expiratory Volume in 1 Second Variability Helps Identify Patients with Cystic Fibrosis at Risk of Greater Loss of Lung Function

Wayne J. Morgan, Donald R. Vandevanter, David J. Pasta, Aimee J. Foreman, Jeffrey S. Wagener, Michael W. Konstan, Ted Liou, Susanna McColley, Ann McMullen, Alexandra Quittner, Warren Regelmann, Clement Ren, Margaret Rosenfeld, Greg Sawicki, Michael Schechter, Marlyn Woo, Dana Brasfield, Raymond Lyrene, Lawrence Sindel, Dion Roberts & 315 others John Carroll, Robert Warren, Louay Nassri, Paula Anderson, Mark Brown, Amy Silverthorn, Peggy Radford, Gerald Gong, Gregory Legris, Gerald Greene, Reddivalam Sudhakar, Arnold Platzker, Bruce Nickerson, Karen Hardy, Ivan Harwood, Gregory Shay, Bryon Quick, Allan Lieberthal, Richard Moss, Chris Landon, Yvonne Fanous, Jay Lieberman, Eugene Spiritus, Bradley Chipps, Ruth McDonald, Mark Pian, Gerd Cropp, Nancy Lewis, Dennis Nielson, Bertrand Shapiro, Frank Accurso, Milene Saavedra, Karen Daigle, Jacob Hen, Regina Palazzo, Kathryn Dodds, Raj Pad-Man, John Goodill, Glenna Winnie, Lea Davies, Tony Kriseman, Jorge Sallent, Joseph Chiaro, Martin Kubiet, Sue Goldfinger, Morton Schwartzman, Carlosenrique Diaz, Kevin Maupin, Eduardo Riff, David Geller, Floyd Livingston, Kunjana Mavunda, Jose Birriel, Luis Faverio, David Rosenberg, David Schaeffer, James Sherman, Mary Wagner, Michael Light, Bruce Schnapf, Gary Montgomery, Kevin Kirchner, Mark Weatherly, Daniel Caplan, Margaret Guill, Valera Hudson, Javeed Akhter, Donald Davison, Steven Boas, Youngran Chung, Rennee Latner, Gabriel Aljadeff, Youngran Chan, Jerome Kraut, Arvey Stone, John Lloyd Still, Girish Sharma, Lanie Eagleton, Patricia Hopkins, Umesh Chatrath, Lucille Lester, Young Jee Kim, Veena Anthony, Howard Eigan, Michelle Howenstine, Pushpom James, Edward Gergesha, James Harris, Robert Plant, Veljko Zivkovich, Angela Collins, Edward Nassif, Richard Ahrens, Daniel Doornbos, Joseph Kanarek, Richard Leff, Pamela Shaw, Elanor Demoss, Maria Riva, Leonard Sullivan, Michael Anstead, Jamshed Kanga, Nemr Eid, Ron Morton, Bettina Hilman, Kim Jones, Scott Davis, Ralph Harder, Tom Lever, Anne Marie Cairns, Edgar Caldwell, Jonathan Zuckerman, Peter Mogayzel, Beryl Rosenstein, John McQuestion, Donna Perry, Samuel Rosenberg, Robert Gerstle, Andrew Colin, Mary Ellen Wohl, Allan Lapey, William Yee, Brian O'Sullivan, Robert Zwerdling, Ibrahim Abdulhamid, Adrian O'Hagan, John Schuen, Lawrence Kurlandsky, Richard Honicky, Douglas Homnick, John Marks, Bohdan Pichurko, Norma Maxvold, Samya Nasr, Richard Simon, Wan Tsai, Dana Kissner, John McNamara, Nancy Henry, Stephen Marker, Michael Pryor, Lynn Walker, Jim Woodward, Louis Mizell, Suzanne Miller, Daniel Rosenbluth, Philip Black, Michael McCubbin, Alan Cohen, Thomas Ferkol, George Mallory, Anthony Rejent, Bruce Rubin, Gavin Graff, Peter Konig, John Colombo, Peter Murphy, William Boyle, Worth Parker, Chandler Patton, Robert Zanni, Arthur Atlas, Nelson Turcios, Lourdes Laraya-Cuasay, Dorothy Bisberg, Helen Aguila, Sarah Allen, David James, Elizabeth Perkett, Marsha Thompson, Sonia Budhecha, Ruben Diaz, Jonathan Rosen, Robert Kaslovsky, Ronald Percciacante, Drucy Borowitz, Joseph Cronin, Colin McMahon, Lynne Quittell, Robert Giusti, Rubin Cohen, Joan Decelie-Germana, Jack Gorvoy, Kalpan Patel, Meyer Kattan, Allen Dozor, Emily Dimango, Maria Berdella, Ran Anbar, Debra Ianuzzi, James Sexton, Catherine Tayag-Kier, John McBride, Karen Voter, Mary Dimaio, John Georgitis, Joseph Marc Majure, Maria Martinez, Clarke McIntosh, Margaret Leigh, Hugh Black, James Hughes, Anand Kantak, Robert Wilmott, Gregory Omlor, Robert Stone, Karen McCoy, James Acton, Carl Doershuk, Robert Fink, Michael Steffan, Pierre Vauthy, Patricia Joseph, Santiago Reyes, John Kramer, James Royall, Jay Eisenberg, Michael Wall, Stanley Fiel, Thomas Scanlin, Shroti Phadke, Joel Weinberg, William Sexauer, Stephen Wolf, Douglas Holsclaw, Debra Klein, Stuart Warren, Robert Kinsey, Carlos Perez, Muttiah Ganeshanathan, James Shinnick, Howard Panitch, Laurie Varlotta, Cynthia Robinson, Jose Rodriguez Santana, Mary Ann Passero, Jane Gwinn, Robert Baker, Michael Bowman, Patrick Flume, Daniel Brown, Roxanne Marville, James Wallace, Rodney Parry, Don Ellenburg, John Rogers, Ricky Mohon, Joel Ledbetter, Aram Hanissian, Robert Schoumacher, Preston Campbell, Christopher Harris, Bonnie Slovis, Dennis Stokes, Kathryn Hale, Marcia Katz, Dan Seilheimer, Marianne Sockrider, Allan Frank, James Daniel, James Cunningham, Iley Browning, John Bray, Amanda Dove, Fernando Mandujano, Larry Tremper, Martha Morse, Donna Willey-Courand, Steven Copenhaver, John Pohl, Bennie McWilliams, Marie Martine-Logvinoff, Marsh Wallace, Robert Klein, Rodolfo Amaro, Leslie Couch, Michael Brown, Claude Prestidge, Stephen Inscore, Andrew Lipton, Barbara Chatfield, Theodore Liou, Bruce Marshall, Thomas Lahiri, Donald Swartz, Laurie Whittaker, Karl Karlson, Ignacio Ropoll, Thomas Rubio, Joel Schmidt, David Thomas, John Osborn, Deborah Froh, Benjamin Gaston, Greg Elliott, Ronald Gibson, Bonnie Ramsey, Michael McCarthy, Lawrence Larson, David Ricker, Mark Robbins, Moira Aitken, Julia Emerson, Stephen Aronoff, Kathryn Moffett, Julie Biller, Mark Splaingard, Bradley Sullivan, Paul Pritchard, Stu Adair, Peter Holzwarth, Guillermo Dopico, Keith Meyer, Christopher Green, Michael Rock

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Objective To evaluate several alternative measures of forced expiratory volume in 1 second percent predicted (FEV1 %pred) variability as potential predictors of future FEV1 %pred decline in patients with cystic fibrosis. Study design We included 13 827 patients age ≥6 years from the Epidemiologic Study of Cystic Fibrosis 1994-2002 with ≥4 FEV1 %pred measurements spanning ≥366 days in both a 2-year baseline period and a 2-year follow-up period. We predicted change from best baseline FEV1 %pred to best follow-up FEV1 %pred and change from baseline to best in the second follow-up year by using multivariable regression stratified by 4 lung-disease stages. We assessed 5 measures of variability (some as deviations from the best and some as deviations from the trend line) both alone and after controlling for demographic and clinical factors and for the slope and level of FEV1 %pred. Results All 5 measures of FEV1 %pred variability were predictive, but the strongest predictor was median deviation from the best FEV1 %pred in the baseline period. The contribution to explanatory power (R2) was substantial and exceeded the total contribution of all other factors excluding the FEV1 %pred rate of decline. Adding the other variability measures provided minimal additional value. Conclusions Median deviation from the best FEV1 %pred is a simple metric that markedly improves prediction of FEV1 %pred decline even after the inclusion of demographic and clinical characteristics and the FEV1 %pred rate of decline. The routine calculation of this variability measure could allow clinicians to better identify patients at risk and therefore in need of increased intervention.

Original languageEnglish (US)
Pages (from-to)116-121e6
JournalJournal of Pediatrics
Volume169
DOIs
StatePublished - Feb 1 2016
Externally publishedYes

Fingerprint

Forced Expiratory Volume
Cystic Fibrosis
Lung
Demography
Lung Diseases
Epidemiologic Studies

Keywords

  • %pred Percent predicted
  • CF Cystic fibrosis
  • FEV Forced expiratory volume in 1 second

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Morgan, W. J., Vandevanter, D. R., Pasta, D. J., Foreman, A. J., Wagener, J. S., Konstan, M. W., ... Rock, M. (2016). Forced Expiratory Volume in 1 Second Variability Helps Identify Patients with Cystic Fibrosis at Risk of Greater Loss of Lung Function. Journal of Pediatrics, 169, 116-121e6. https://doi.org/10.1016/j.jpeds.2015.08.042

Forced Expiratory Volume in 1 Second Variability Helps Identify Patients with Cystic Fibrosis at Risk of Greater Loss of Lung Function. / Morgan, Wayne J.; Vandevanter, Donald R.; Pasta, David J.; Foreman, Aimee J.; Wagener, Jeffrey S.; Konstan, Michael W.; Liou, Ted; McColley, Susanna; McMullen, Ann; Quittner, Alexandra; Regelmann, Warren; Ren, Clement; Rosenfeld, Margaret; Sawicki, Greg; Schechter, Michael; Woo, Marlyn; Brasfield, Dana; Lyrene, Raymond; Sindel, Lawrence; Roberts, Dion; Carroll, John; Warren, Robert; Nassri, Louay; Anderson, Paula; Brown, Mark; Silverthorn, Amy; Radford, Peggy; Gong, Gerald; Legris, Gregory; Greene, Gerald; Sudhakar, Reddivalam; Platzker, Arnold; Nickerson, Bruce; Hardy, Karen; Harwood, Ivan; Shay, Gregory; Quick, Bryon; Lieberthal, Allan; Moss, Richard; Landon, Chris; Fanous, Yvonne; Lieberman, Jay; Spiritus, Eugene; Chipps, Bradley; McDonald, Ruth; Pian, Mark; Cropp, Gerd; Lewis, Nancy; Nielson, Dennis; Shapiro, Bertrand; Accurso, Frank; Saavedra, Milene; Daigle, Karen; Hen, Jacob; Palazzo, Regina; Dodds, Kathryn; Pad-Man, Raj; Goodill, John; Winnie, Glenna; Davies, Lea; Kriseman, Tony; Sallent, Jorge; Chiaro, Joseph; Kubiet, Martin; Goldfinger, Sue; Schwartzman, Morton; Diaz, Carlosenrique; Maupin, Kevin; Riff, Eduardo; Geller, David; Livingston, Floyd; Mavunda, Kunjana; Birriel, Jose; Faverio, Luis; Rosenberg, David; Schaeffer, David; Sherman, James; Wagner, Mary; Light, Michael; Schnapf, Bruce; Montgomery, Gary; Kirchner, Kevin; Weatherly, Mark; Caplan, Daniel; Guill, Margaret; Hudson, Valera; Akhter, Javeed; Davison, Donald; Boas, Steven; Chung, Youngran; Latner, Rennee; Aljadeff, Gabriel; Chan, Youngran; Kraut, Jerome; Stone, Arvey; Still, John Lloyd; Sharma, Girish; Eagleton, Lanie; Hopkins, Patricia; Chatrath, Umesh; Lester, Lucille; Kim, Young Jee; Anthony, Veena; Eigan, Howard; Howenstine, Michelle; James, Pushpom; Gergesha, Edward; Harris, James; Plant, Robert; Zivkovich, Veljko; Collins, Angela; Nassif, Edward; Ahrens, Richard; Doornbos, Daniel; Kanarek, Joseph; Leff, Richard; Shaw, Pamela; Demoss, Elanor; Riva, Maria; Sullivan, Leonard; Anstead, Michael; Kanga, Jamshed; Eid, Nemr; Morton, Ron; Hilman, Bettina; Jones, Kim; Davis, Scott; Harder, Ralph; Lever, Tom; Cairns, Anne Marie; Caldwell, Edgar; Zuckerman, Jonathan; Mogayzel, Peter; Rosenstein, Beryl; McQuestion, John; Perry, Donna; Rosenberg, Samuel; Gerstle, Robert; Colin, Andrew; Wohl, Mary Ellen; Lapey, Allan; Yee, William; O'Sullivan, Brian; Zwerdling, Robert; Abdulhamid, Ibrahim; O'Hagan, Adrian; Schuen, John; Kurlandsky, Lawrence; Honicky, Richard; Homnick, Douglas; Marks, John; Pichurko, Bohdan; Maxvold, Norma; Nasr, Samya; Simon, Richard; Tsai, Wan; Kissner, Dana; McNamara, John; Henry, Nancy; Marker, Stephen; Pryor, Michael; Walker, Lynn; Woodward, Jim; Mizell, Louis; Miller, Suzanne; Rosenbluth, Daniel; Black, Philip; McCubbin, Michael; Cohen, Alan; Ferkol, Thomas; Mallory, George; Rejent, Anthony; Rubin, Bruce; Graff, Gavin; Konig, Peter; Colombo, John; Murphy, Peter; Boyle, William; Parker, Worth; Patton, Chandler; Zanni, Robert; Atlas, Arthur; Turcios, Nelson; Laraya-Cuasay, Lourdes; Bisberg, Dorothy; Aguila, Helen; Allen, Sarah; James, David; Perkett, Elizabeth; Thompson, Marsha; Budhecha, Sonia; Diaz, Ruben; Rosen, Jonathan; Kaslovsky, Robert; Percciacante, Ronald; Borowitz, Drucy; Cronin, Joseph; McMahon, Colin; Quittell, Lynne; Giusti, Robert; Cohen, Rubin; Decelie-Germana, Joan; Gorvoy, Jack; Patel, Kalpan; Kattan, Meyer; Dozor, Allen; Dimango, Emily; Berdella, Maria; Anbar, Ran; Ianuzzi, Debra; Sexton, James; Tayag-Kier, Catherine; McBride, John; Voter, Karen; Dimaio, Mary; Georgitis, John; Majure, Joseph Marc; Martinez, Maria; McIntosh, Clarke; Leigh, Margaret; Black, Hugh; Hughes, James; Kantak, Anand; Wilmott, Robert; Omlor, Gregory; Stone, Robert; McCoy, Karen; Acton, James; Doershuk, Carl; Fink, Robert; Steffan, Michael; Vauthy, Pierre; Joseph, Patricia; Reyes, Santiago; Kramer, John; Royall, James; Eisenberg, Jay; Wall, Michael; Fiel, Stanley; Scanlin, Thomas; Phadke, Shroti; Weinberg, Joel; Sexauer, William; Wolf, Stephen; Holsclaw, Douglas; Klein, Debra; Warren, Stuart; Kinsey, Robert; Perez, Carlos; Ganeshanathan, Muttiah; Shinnick, James; Panitch, Howard; Varlotta, Laurie; Robinson, Cynthia; Santana, Jose Rodriguez; Passero, Mary Ann; Gwinn, Jane; Baker, Robert; Bowman, Michael; Flume, Patrick; Brown, Daniel; Marville, Roxanne; Wallace, James; Parry, Rodney; Ellenburg, Don; Rogers, John; Mohon, Ricky; Ledbetter, Joel; Hanissian, Aram; Schoumacher, Robert; Campbell, Preston; Harris, Christopher; Slovis, Bonnie; Stokes, Dennis; Hale, Kathryn; Katz, Marcia; Seilheimer, Dan; Sockrider, Marianne; Frank, Allan; Daniel, James; Cunningham, James; Browning, Iley; Bray, John; Dove, Amanda; Mandujano, Fernando; Tremper, Larry; Morse, Martha; Willey-Courand, Donna; Copenhaver, Steven; Pohl, John; McWilliams, Bennie; Martine-Logvinoff, Marie; Wallace, Marsh; Klein, Robert; Amaro, Rodolfo; Couch, Leslie; Brown, Michael; Prestidge, Claude; Inscore, Stephen; Lipton, Andrew; Chatfield, Barbara; Liou, Theodore; Marshall, Bruce; Lahiri, Thomas; Swartz, Donald; Whittaker, Laurie; Karlson, Karl; Ropoll, Ignacio; Rubio, Thomas; Schmidt, Joel; Thomas, David; Osborn, John; Froh, Deborah; Gaston, Benjamin; Elliott, Greg; Gibson, Ronald; Ramsey, Bonnie; McCarthy, Michael; Larson, Lawrence; Ricker, David; Robbins, Mark; Aitken, Moira; Emerson, Julia; Aronoff, Stephen; Moffett, Kathryn; Biller, Julie; Splaingard, Mark; Sullivan, Bradley; Pritchard, Paul; Adair, Stu; Holzwarth, Peter; Dopico, Guillermo; Meyer, Keith; Green, Christopher; Rock, Michael.

In: Journal of Pediatrics, Vol. 169, 01.02.2016, p. 116-121e6.

Research output: Contribution to journalArticle

Morgan, WJ, Vandevanter, DR, Pasta, DJ, Foreman, AJ, Wagener, JS, Konstan, MW, Liou, T, McColley, S, McMullen, A, Quittner, A, Regelmann, W, Ren, C, Rosenfeld, M, Sawicki, G, Schechter, M, Woo, M, Brasfield, D, Lyrene, R, Sindel, L, Roberts, D, Carroll, J, Warren, R, Nassri, L, Anderson, P, Brown, M, Silverthorn, A, Radford, P, Gong, G, Legris, G, Greene, G, Sudhakar, R, Platzker, A, Nickerson, B, Hardy, K, Harwood, I, Shay, G, Quick, B, Lieberthal, A, Moss, R, Landon, C, Fanous, Y, Lieberman, J, Spiritus, E, Chipps, B, McDonald, R, Pian, M, Cropp, G, Lewis, N, Nielson, D, Shapiro, B, Accurso, F, Saavedra, M, Daigle, K, Hen, J, Palazzo, R, Dodds, K, Pad-Man, R, Goodill, J, Winnie, G, Davies, L, Kriseman, T, Sallent, J, Chiaro, J, Kubiet, M, Goldfinger, S, Schwartzman, M, Diaz, C, Maupin, K, Riff, E, Geller, D, Livingston, F, Mavunda, K, Birriel, J, Faverio, L, Rosenberg, D, Schaeffer, D, Sherman, J, Wagner, M, Light, M, Schnapf, B, Montgomery, G, Kirchner, K, Weatherly, M, Caplan, D, Guill, M, Hudson, V, Akhter, J, Davison, D, Boas, S, Chung, Y, Latner, R, Aljadeff, G, Chan, Y, Kraut, J, Stone, A, Still, JL, Sharma, G, Eagleton, L, Hopkins, P, Chatrath, U, Lester, L, Kim, YJ, Anthony, V, Eigan, H, Howenstine, M, James, P, Gergesha, E, Harris, J, Plant, R, Zivkovich, V, Collins, A, Nassif, E, Ahrens, R, Doornbos, D, Kanarek, J, Leff, R, Shaw, P, Demoss, E, Riva, M, Sullivan, L, Anstead, M, Kanga, J, Eid, N, Morton, R, Hilman, B, Jones, K, Davis, S, Harder, R, Lever, T, Cairns, AM, Caldwell, E, Zuckerman, J, Mogayzel, P, Rosenstein, B, McQuestion, J, Perry, D, Rosenberg, S, Gerstle, R, Colin, A, Wohl, ME, Lapey, A, Yee, W, O'Sullivan, B, Zwerdling, R, Abdulhamid, I, O'Hagan, A, Schuen, J, Kurlandsky, L, Honicky, R, Homnick, D, Marks, J, Pichurko, B, Maxvold, N, Nasr, S, Simon, R, Tsai, W, Kissner, D, McNamara, J, Henry, N, Marker, S, Pryor, M, Walker, L, Woodward, J, Mizell, L, Miller, S, Rosenbluth, D, Black, P, McCubbin, M, Cohen, A, Ferkol, T, Mallory, G, Rejent, A, Rubin, B, Graff, G, Konig, P, Colombo, J, Murphy, P, Boyle, W, Parker, W, Patton, C, Zanni, R, Atlas, A, Turcios, N, Laraya-Cuasay, L, Bisberg, D, Aguila, H, Allen, S, James, D, Perkett, E, Thompson, M, Budhecha, S, Diaz, R, Rosen, J, Kaslovsky, R, Percciacante, R, Borowitz, D, Cronin, J, McMahon, C, Quittell, L, Giusti, R, Cohen, R, Decelie-Germana, J, Gorvoy, J, Patel, K, Kattan, M, Dozor, A, Dimango, E, Berdella, M, Anbar, R, Ianuzzi, D, Sexton, J, Tayag-Kier, C, McBride, J, Voter, K, Dimaio, M, Georgitis, J, Majure, JM, Martinez, M, McIntosh, C, Leigh, M, Black, H, Hughes, J, Kantak, A, Wilmott, R, Omlor, G, Stone, R, McCoy, K, Acton, J, Doershuk, C, Fink, R, Steffan, M, Vauthy, P, Joseph, P, Reyes, S, Kramer, J, Royall, J, Eisenberg, J, Wall, M, Fiel, S, Scanlin, T, Phadke, S, Weinberg, J, Sexauer, W, Wolf, S, Holsclaw, D, Klein, D, Warren, S, Kinsey, R, Perez, C, Ganeshanathan, M, Shinnick, J, Panitch, H, Varlotta, L, Robinson, C, Santana, JR, Passero, MA, Gwinn, J, Baker, R, Bowman, M, Flume, P, Brown, D, Marville, R, Wallace, J, Parry, R, Ellenburg, D, Rogers, J, Mohon, R, Ledbetter, J, Hanissian, A, Schoumacher, R, Campbell, P, Harris, C, Slovis, B, Stokes, D, Hale, K, Katz, M, Seilheimer, D, Sockrider, M, Frank, A, Daniel, J, Cunningham, J, Browning, I, Bray, J, Dove, A, Mandujano, F, Tremper, L, Morse, M, Willey-Courand, D, Copenhaver, S, Pohl, J, McWilliams, B, Martine-Logvinoff, M, Wallace, M, Klein, R, Amaro, R, Couch, L, Brown, M, Prestidge, C, Inscore, S, Lipton, A, Chatfield, B, Liou, T, Marshall, B, Lahiri, T, Swartz, D, Whittaker, L, Karlson, K, Ropoll, I, Rubio, T, Schmidt, J, Thomas, D, Osborn, J, Froh, D, Gaston, B, Elliott, G, Gibson, R, Ramsey, B, McCarthy, M, Larson, L, Ricker, D, Robbins, M, Aitken, M, Emerson, J, Aronoff, S, Moffett, K, Biller, J, Splaingard, M, Sullivan, B, Pritchard, P, Adair, S, Holzwarth, P, Dopico, G, Meyer, K, Green, C & Rock, M 2016, 'Forced Expiratory Volume in 1 Second Variability Helps Identify Patients with Cystic Fibrosis at Risk of Greater Loss of Lung Function', Journal of Pediatrics, vol. 169, pp. 116-121e6. https://doi.org/10.1016/j.jpeds.2015.08.042
Morgan, Wayne J. ; Vandevanter, Donald R. ; Pasta, David J. ; Foreman, Aimee J. ; Wagener, Jeffrey S. ; Konstan, Michael W. ; Liou, Ted ; McColley, Susanna ; McMullen, Ann ; Quittner, Alexandra ; Regelmann, Warren ; Ren, Clement ; Rosenfeld, Margaret ; Sawicki, Greg ; Schechter, Michael ; Woo, Marlyn ; Brasfield, Dana ; Lyrene, Raymond ; Sindel, Lawrence ; Roberts, Dion ; Carroll, John ; Warren, Robert ; Nassri, Louay ; Anderson, Paula ; Brown, Mark ; Silverthorn, Amy ; Radford, Peggy ; Gong, Gerald ; Legris, Gregory ; Greene, Gerald ; Sudhakar, Reddivalam ; Platzker, Arnold ; Nickerson, Bruce ; Hardy, Karen ; Harwood, Ivan ; Shay, Gregory ; Quick, Bryon ; Lieberthal, Allan ; Moss, Richard ; Landon, Chris ; Fanous, Yvonne ; Lieberman, Jay ; Spiritus, Eugene ; Chipps, Bradley ; McDonald, Ruth ; Pian, Mark ; Cropp, Gerd ; Lewis, Nancy ; Nielson, Dennis ; Shapiro, Bertrand ; Accurso, Frank ; Saavedra, Milene ; Daigle, Karen ; Hen, Jacob ; Palazzo, Regina ; Dodds, Kathryn ; Pad-Man, Raj ; Goodill, John ; Winnie, Glenna ; Davies, Lea ; Kriseman, Tony ; Sallent, Jorge ; Chiaro, Joseph ; Kubiet, Martin ; Goldfinger, Sue ; Schwartzman, Morton ; Diaz, Carlosenrique ; Maupin, Kevin ; Riff, Eduardo ; Geller, David ; Livingston, Floyd ; Mavunda, Kunjana ; Birriel, Jose ; Faverio, Luis ; Rosenberg, David ; Schaeffer, David ; Sherman, James ; Wagner, Mary ; Light, Michael ; Schnapf, Bruce ; Montgomery, Gary ; Kirchner, Kevin ; Weatherly, Mark ; Caplan, Daniel ; Guill, Margaret ; Hudson, Valera ; Akhter, Javeed ; Davison, Donald ; Boas, Steven ; Chung, Youngran ; Latner, Rennee ; Aljadeff, Gabriel ; Chan, Youngran ; Kraut, Jerome ; Stone, Arvey ; Still, John Lloyd ; Sharma, Girish ; Eagleton, Lanie ; Hopkins, Patricia ; Chatrath, Umesh ; Lester, Lucille ; Kim, Young Jee ; Anthony, Veena ; Eigan, Howard ; Howenstine, Michelle ; James, Pushpom ; Gergesha, Edward ; Harris, James ; Plant, Robert ; Zivkovich, Veljko ; Collins, Angela ; Nassif, Edward ; Ahrens, Richard ; Doornbos, Daniel ; Kanarek, Joseph ; Leff, Richard ; Shaw, Pamela ; Demoss, Elanor ; Riva, Maria ; Sullivan, Leonard ; Anstead, Michael ; Kanga, Jamshed ; Eid, Nemr ; Morton, Ron ; Hilman, Bettina ; Jones, Kim ; Davis, Scott ; Harder, Ralph ; Lever, Tom ; Cairns, Anne Marie ; Caldwell, Edgar ; Zuckerman, Jonathan ; Mogayzel, Peter ; Rosenstein, Beryl ; McQuestion, John ; Perry, Donna ; Rosenberg, Samuel ; Gerstle, Robert ; Colin, Andrew ; Wohl, Mary Ellen ; Lapey, Allan ; Yee, William ; O'Sullivan, Brian ; Zwerdling, Robert ; Abdulhamid, Ibrahim ; O'Hagan, Adrian ; Schuen, John ; Kurlandsky, Lawrence ; Honicky, Richard ; Homnick, Douglas ; Marks, John ; Pichurko, Bohdan ; Maxvold, Norma ; Nasr, Samya ; Simon, Richard ; Tsai, Wan ; Kissner, Dana ; McNamara, John ; Henry, Nancy ; Marker, Stephen ; Pryor, Michael ; Walker, Lynn ; Woodward, Jim ; Mizell, Louis ; Miller, Suzanne ; Rosenbluth, Daniel ; Black, Philip ; McCubbin, Michael ; Cohen, Alan ; Ferkol, Thomas ; Mallory, George ; Rejent, Anthony ; Rubin, Bruce ; Graff, Gavin ; Konig, Peter ; Colombo, John ; Murphy, Peter ; Boyle, William ; Parker, Worth ; Patton, Chandler ; Zanni, Robert ; Atlas, Arthur ; Turcios, Nelson ; Laraya-Cuasay, Lourdes ; Bisberg, Dorothy ; Aguila, Helen ; Allen, Sarah ; James, David ; Perkett, Elizabeth ; Thompson, Marsha ; Budhecha, Sonia ; Diaz, Ruben ; Rosen, Jonathan ; Kaslovsky, Robert ; Percciacante, Ronald ; Borowitz, Drucy ; Cronin, Joseph ; McMahon, Colin ; Quittell, Lynne ; Giusti, Robert ; Cohen, Rubin ; Decelie-Germana, Joan ; Gorvoy, Jack ; Patel, Kalpan ; Kattan, Meyer ; Dozor, Allen ; Dimango, Emily ; Berdella, Maria ; Anbar, Ran ; Ianuzzi, Debra ; Sexton, James ; Tayag-Kier, Catherine ; McBride, John ; Voter, Karen ; Dimaio, Mary ; Georgitis, John ; Majure, Joseph Marc ; Martinez, Maria ; McIntosh, Clarke ; Leigh, Margaret ; Black, Hugh ; Hughes, James ; Kantak, Anand ; Wilmott, Robert ; Omlor, Gregory ; Stone, Robert ; McCoy, Karen ; Acton, James ; Doershuk, Carl ; Fink, Robert ; Steffan, Michael ; Vauthy, Pierre ; Joseph, Patricia ; Reyes, Santiago ; Kramer, John ; Royall, James ; Eisenberg, Jay ; Wall, Michael ; Fiel, Stanley ; Scanlin, Thomas ; Phadke, Shroti ; Weinberg, Joel ; Sexauer, William ; Wolf, Stephen ; Holsclaw, Douglas ; Klein, Debra ; Warren, Stuart ; Kinsey, Robert ; Perez, Carlos ; Ganeshanathan, Muttiah ; Shinnick, James ; Panitch, Howard ; Varlotta, Laurie ; Robinson, Cynthia ; Santana, Jose Rodriguez ; Passero, Mary Ann ; Gwinn, Jane ; Baker, Robert ; Bowman, Michael ; Flume, Patrick ; Brown, Daniel ; Marville, Roxanne ; Wallace, James ; Parry, Rodney ; Ellenburg, Don ; Rogers, John ; Mohon, Ricky ; Ledbetter, Joel ; Hanissian, Aram ; Schoumacher, Robert ; Campbell, Preston ; Harris, Christopher ; Slovis, Bonnie ; Stokes, Dennis ; Hale, Kathryn ; Katz, Marcia ; Seilheimer, Dan ; Sockrider, Marianne ; Frank, Allan ; Daniel, James ; Cunningham, James ; Browning, Iley ; Bray, John ; Dove, Amanda ; Mandujano, Fernando ; Tremper, Larry ; Morse, Martha ; Willey-Courand, Donna ; Copenhaver, Steven ; Pohl, John ; McWilliams, Bennie ; Martine-Logvinoff, Marie ; Wallace, Marsh ; Klein, Robert ; Amaro, Rodolfo ; Couch, Leslie ; Brown, Michael ; Prestidge, Claude ; Inscore, Stephen ; Lipton, Andrew ; Chatfield, Barbara ; Liou, Theodore ; Marshall, Bruce ; Lahiri, Thomas ; Swartz, Donald ; Whittaker, Laurie ; Karlson, Karl ; Ropoll, Ignacio ; Rubio, Thomas ; Schmidt, Joel ; Thomas, David ; Osborn, John ; Froh, Deborah ; Gaston, Benjamin ; Elliott, Greg ; Gibson, Ronald ; Ramsey, Bonnie ; McCarthy, Michael ; Larson, Lawrence ; Ricker, David ; Robbins, Mark ; Aitken, Moira ; Emerson, Julia ; Aronoff, Stephen ; Moffett, Kathryn ; Biller, Julie ; Splaingard, Mark ; Sullivan, Bradley ; Pritchard, Paul ; Adair, Stu ; Holzwarth, Peter ; Dopico, Guillermo ; Meyer, Keith ; Green, Christopher ; Rock, Michael. / Forced Expiratory Volume in 1 Second Variability Helps Identify Patients with Cystic Fibrosis at Risk of Greater Loss of Lung Function. In: Journal of Pediatrics. 2016 ; Vol. 169. pp. 116-121e6.
@article{32a4880e10d7458797fd737b2a7e7f7a,
title = "Forced Expiratory Volume in 1 Second Variability Helps Identify Patients with Cystic Fibrosis at Risk of Greater Loss of Lung Function",
abstract = "Objective To evaluate several alternative measures of forced expiratory volume in 1 second percent predicted (FEV1 {\%}pred) variability as potential predictors of future FEV1 {\%}pred decline in patients with cystic fibrosis. Study design We included 13 827 patients age ≥6 years from the Epidemiologic Study of Cystic Fibrosis 1994-2002 with ≥4 FEV1 {\%}pred measurements spanning ≥366 days in both a 2-year baseline period and a 2-year follow-up period. We predicted change from best baseline FEV1 {\%}pred to best follow-up FEV1 {\%}pred and change from baseline to best in the second follow-up year by using multivariable regression stratified by 4 lung-disease stages. We assessed 5 measures of variability (some as deviations from the best and some as deviations from the trend line) both alone and after controlling for demographic and clinical factors and for the slope and level of FEV1 {\%}pred. Results All 5 measures of FEV1 {\%}pred variability were predictive, but the strongest predictor was median deviation from the best FEV1 {\%}pred in the baseline period. The contribution to explanatory power (R2) was substantial and exceeded the total contribution of all other factors excluding the FEV1 {\%}pred rate of decline. Adding the other variability measures provided minimal additional value. Conclusions Median deviation from the best FEV1 {\%}pred is a simple metric that markedly improves prediction of FEV1 {\%}pred decline even after the inclusion of demographic and clinical characteristics and the FEV1 {\%}pred rate of decline. The routine calculation of this variability measure could allow clinicians to better identify patients at risk and therefore in need of increased intervention.",
keywords = "{\%}pred Percent predicted, CF Cystic fibrosis, FEV Forced expiratory volume in 1 second",
author = "Morgan, {Wayne J.} and Vandevanter, {Donald R.} and Pasta, {David J.} and Foreman, {Aimee J.} and Wagener, {Jeffrey S.} and Konstan, {Michael W.} and Ted Liou and Susanna McColley and Ann McMullen and Alexandra Quittner and Warren Regelmann and Clement Ren and Margaret Rosenfeld and Greg Sawicki and Michael Schechter and Marlyn Woo and Dana Brasfield and Raymond Lyrene and Lawrence Sindel and Dion Roberts and John Carroll and Robert Warren and Louay Nassri and Paula Anderson and Mark Brown and Amy Silverthorn and Peggy Radford and Gerald Gong and Gregory Legris and Gerald Greene and Reddivalam Sudhakar and Arnold Platzker and Bruce Nickerson and Karen Hardy and Ivan Harwood and Gregory Shay and Bryon Quick and Allan Lieberthal and Richard Moss and Chris Landon and Yvonne Fanous and Jay Lieberman and Eugene Spiritus and Bradley Chipps and Ruth McDonald and Mark Pian and Gerd Cropp and Nancy Lewis and Dennis Nielson and Bertrand Shapiro and Frank Accurso and Milene Saavedra and Karen Daigle and Jacob Hen and Regina Palazzo and Kathryn Dodds and Raj Pad-Man and John Goodill and Glenna Winnie and Lea Davies and Tony Kriseman and Jorge Sallent and Joseph Chiaro and Martin Kubiet and Sue Goldfinger and Morton Schwartzman and Carlosenrique Diaz and Kevin Maupin and Eduardo Riff and David Geller and Floyd Livingston and Kunjana Mavunda and Jose Birriel and Luis Faverio and David Rosenberg and David Schaeffer and James Sherman and Mary Wagner and Michael Light and Bruce Schnapf and Gary Montgomery and Kevin Kirchner and Mark Weatherly and Daniel Caplan and Margaret Guill and Valera Hudson and Javeed Akhter and Donald Davison and Steven Boas and Youngran Chung and Rennee Latner and Gabriel Aljadeff and Youngran Chan and Jerome Kraut and Arvey Stone and Still, {John Lloyd} and Girish Sharma and Lanie Eagleton and Patricia Hopkins and Umesh Chatrath and Lucille Lester and Kim, {Young Jee} and Veena Anthony and Howard Eigan and Michelle Howenstine and Pushpom James and Edward Gergesha and James Harris and Robert Plant and Veljko Zivkovich and Angela Collins and Edward Nassif and Richard Ahrens and Daniel Doornbos and Joseph Kanarek and Richard Leff and Pamela Shaw and Elanor Demoss and Maria Riva and Leonard Sullivan and Michael Anstead and Jamshed Kanga and Nemr Eid and Ron Morton and Bettina Hilman and Kim Jones and Scott Davis and Ralph Harder and Tom Lever and Cairns, {Anne Marie} and Edgar Caldwell and Jonathan Zuckerman and Peter Mogayzel and Beryl Rosenstein and John McQuestion and Donna Perry and Samuel Rosenberg and Robert Gerstle and Andrew Colin and Wohl, {Mary Ellen} and Allan Lapey and William Yee and Brian O'Sullivan and Robert Zwerdling and Ibrahim Abdulhamid and Adrian O'Hagan and John Schuen and Lawrence Kurlandsky and Richard Honicky and Douglas Homnick and John Marks and Bohdan Pichurko and Norma Maxvold and Samya Nasr and Richard Simon and Wan Tsai and Dana Kissner and John McNamara and Nancy Henry and Stephen Marker and Michael Pryor and Lynn Walker and Jim Woodward and Louis Mizell and Suzanne Miller and Daniel Rosenbluth and Philip Black and Michael McCubbin and Alan Cohen and Thomas Ferkol and George Mallory and Anthony Rejent and Bruce Rubin and Gavin Graff and Peter Konig and John Colombo and Peter Murphy and William Boyle and Worth Parker and Chandler Patton and Robert Zanni and Arthur Atlas and Nelson Turcios and Lourdes Laraya-Cuasay and Dorothy Bisberg and Helen Aguila and Sarah Allen and David James and Elizabeth Perkett and Marsha Thompson and Sonia Budhecha and Ruben Diaz and Jonathan Rosen and Robert Kaslovsky and Ronald Percciacante and Drucy Borowitz and Joseph Cronin and Colin McMahon and Lynne Quittell and Robert Giusti and Rubin Cohen and Joan Decelie-Germana and Jack Gorvoy and Kalpan Patel and Meyer Kattan and Allen Dozor and Emily Dimango and Maria Berdella and Ran Anbar and Debra Ianuzzi and James Sexton and Catherine Tayag-Kier and John McBride and Karen Voter and Mary Dimaio and John Georgitis and Majure, {Joseph Marc} and Maria Martinez and Clarke McIntosh and Margaret Leigh and Hugh Black and James Hughes and Anand Kantak and Robert Wilmott and Gregory Omlor and Robert Stone and Karen McCoy and James Acton and Carl Doershuk and Robert Fink and Michael Steffan and Pierre Vauthy and Patricia Joseph and Santiago Reyes and John Kramer and James Royall and Jay Eisenberg and Michael Wall and Stanley Fiel and Thomas Scanlin and Shroti Phadke and Joel Weinberg and William Sexauer and Stephen Wolf and Douglas Holsclaw and Debra Klein and Stuart Warren and Robert Kinsey and Carlos Perez and Muttiah Ganeshanathan and James Shinnick and Howard Panitch and Laurie Varlotta and Cynthia Robinson and Santana, {Jose Rodriguez} and Passero, {Mary Ann} and Jane Gwinn and Robert Baker and Michael Bowman and Patrick Flume and Daniel Brown and Roxanne Marville and James Wallace and Rodney Parry and Don Ellenburg and John Rogers and Ricky Mohon and Joel Ledbetter and Aram Hanissian and Robert Schoumacher and Preston Campbell and Christopher Harris and Bonnie Slovis and Dennis Stokes and Kathryn Hale and Marcia Katz and Dan Seilheimer and Marianne Sockrider and Allan Frank and James Daniel and James Cunningham and Iley Browning and John Bray and Amanda Dove and Fernando Mandujano and Larry Tremper and Martha Morse and Donna Willey-Courand and Steven Copenhaver and John Pohl and Bennie McWilliams and Marie Martine-Logvinoff and Marsh Wallace and Robert Klein and Rodolfo Amaro and Leslie Couch and Michael Brown and Claude Prestidge and Stephen Inscore and Andrew Lipton and Barbara Chatfield and Theodore Liou and Bruce Marshall and Thomas Lahiri and Donald Swartz and Laurie Whittaker and Karl Karlson and Ignacio Ropoll and Thomas Rubio and Joel Schmidt and David Thomas and John Osborn and Deborah Froh and Benjamin Gaston and Greg Elliott and Ronald Gibson and Bonnie Ramsey and Michael McCarthy and Lawrence Larson and David Ricker and Mark Robbins and Moira Aitken and Julia Emerson and Stephen Aronoff and Kathryn Moffett and Julie Biller and Mark Splaingard and Bradley Sullivan and Paul Pritchard and Stu Adair and Peter Holzwarth and Guillermo Dopico and Keith Meyer and Christopher Green and Michael Rock",
year = "2016",
month = "2",
day = "1",
doi = "10.1016/j.jpeds.2015.08.042",
language = "English (US)",
volume = "169",
pages = "116--121e6",
journal = "Journal of Pediatrics",
issn = "0022-3476",
publisher = "Mosby Inc.",

}

TY - JOUR

T1 - Forced Expiratory Volume in 1 Second Variability Helps Identify Patients with Cystic Fibrosis at Risk of Greater Loss of Lung Function

AU - Morgan, Wayne J.

AU - Vandevanter, Donald R.

AU - Pasta, David J.

AU - Foreman, Aimee J.

AU - Wagener, Jeffrey S.

AU - Konstan, Michael W.

AU - Liou, Ted

AU - McColley, Susanna

AU - McMullen, Ann

AU - Quittner, Alexandra

AU - Regelmann, Warren

AU - Ren, Clement

AU - Rosenfeld, Margaret

AU - Sawicki, Greg

AU - Schechter, Michael

AU - Woo, Marlyn

AU - Brasfield, Dana

AU - Lyrene, Raymond

AU - Sindel, Lawrence

AU - Roberts, Dion

AU - Carroll, John

AU - Warren, Robert

AU - Nassri, Louay

AU - Anderson, Paula

AU - Brown, Mark

AU - Silverthorn, Amy

AU - Radford, Peggy

AU - Gong, Gerald

AU - Legris, Gregory

AU - Greene, Gerald

AU - Sudhakar, Reddivalam

AU - Platzker, Arnold

AU - Nickerson, Bruce

AU - Hardy, Karen

AU - Harwood, Ivan

AU - Shay, Gregory

AU - Quick, Bryon

AU - Lieberthal, Allan

AU - Moss, Richard

AU - Landon, Chris

AU - Fanous, Yvonne

AU - Lieberman, Jay

AU - Spiritus, Eugene

AU - Chipps, Bradley

AU - McDonald, Ruth

AU - Pian, Mark

AU - Cropp, Gerd

AU - Lewis, Nancy

AU - Nielson, Dennis

AU - Shapiro, Bertrand

AU - Accurso, Frank

AU - Saavedra, Milene

AU - Daigle, Karen

AU - Hen, Jacob

AU - Palazzo, Regina

AU - Dodds, Kathryn

AU - Pad-Man, Raj

AU - Goodill, John

AU - Winnie, Glenna

AU - Davies, Lea

AU - Kriseman, Tony

AU - Sallent, Jorge

AU - Chiaro, Joseph

AU - Kubiet, Martin

AU - Goldfinger, Sue

AU - Schwartzman, Morton

AU - Diaz, Carlosenrique

AU - Maupin, Kevin

AU - Riff, Eduardo

AU - Geller, David

AU - Livingston, Floyd

AU - Mavunda, Kunjana

AU - Birriel, Jose

AU - Faverio, Luis

AU - Rosenberg, David

AU - Schaeffer, David

AU - Sherman, James

AU - Wagner, Mary

AU - Light, Michael

AU - Schnapf, Bruce

AU - Montgomery, Gary

AU - Kirchner, Kevin

AU - Weatherly, Mark

AU - Caplan, Daniel

AU - Guill, Margaret

AU - Hudson, Valera

AU - Akhter, Javeed

AU - Davison, Donald

AU - Boas, Steven

AU - Chung, Youngran

AU - Latner, Rennee

AU - Aljadeff, Gabriel

AU - Chan, Youngran

AU - Kraut, Jerome

AU - Stone, Arvey

AU - Still, John Lloyd

AU - Sharma, Girish

AU - Eagleton, Lanie

AU - Hopkins, Patricia

AU - Chatrath, Umesh

AU - Lester, Lucille

AU - Kim, Young Jee

AU - Anthony, Veena

AU - Eigan, Howard

AU - Howenstine, Michelle

AU - James, Pushpom

AU - Gergesha, Edward

AU - Harris, James

AU - Plant, Robert

AU - Zivkovich, Veljko

AU - Collins, Angela

AU - Nassif, Edward

AU - Ahrens, Richard

AU - Doornbos, Daniel

AU - Kanarek, Joseph

AU - Leff, Richard

AU - Shaw, Pamela

AU - Demoss, Elanor

AU - Riva, Maria

AU - Sullivan, Leonard

AU - Anstead, Michael

AU - Kanga, Jamshed

AU - Eid, Nemr

AU - Morton, Ron

AU - Hilman, Bettina

AU - Jones, Kim

AU - Davis, Scott

AU - Harder, Ralph

AU - Lever, Tom

AU - Cairns, Anne Marie

AU - Caldwell, Edgar

AU - Zuckerman, Jonathan

AU - Mogayzel, Peter

AU - Rosenstein, Beryl

AU - McQuestion, John

AU - Perry, Donna

AU - Rosenberg, Samuel

AU - Gerstle, Robert

AU - Colin, Andrew

AU - Wohl, Mary Ellen

AU - Lapey, Allan

AU - Yee, William

AU - O'Sullivan, Brian

AU - Zwerdling, Robert

AU - Abdulhamid, Ibrahim

AU - O'Hagan, Adrian

AU - Schuen, John

AU - Kurlandsky, Lawrence

AU - Honicky, Richard

AU - Homnick, Douglas

AU - Marks, John

AU - Pichurko, Bohdan

AU - Maxvold, Norma

AU - Nasr, Samya

AU - Simon, Richard

AU - Tsai, Wan

AU - Kissner, Dana

AU - McNamara, John

AU - Henry, Nancy

AU - Marker, Stephen

AU - Pryor, Michael

AU - Walker, Lynn

AU - Woodward, Jim

AU - Mizell, Louis

AU - Miller, Suzanne

AU - Rosenbluth, Daniel

AU - Black, Philip

AU - McCubbin, Michael

AU - Cohen, Alan

AU - Ferkol, Thomas

AU - Mallory, George

AU - Rejent, Anthony

AU - Rubin, Bruce

AU - Graff, Gavin

AU - Konig, Peter

AU - Colombo, John

AU - Murphy, Peter

AU - Boyle, William

AU - Parker, Worth

AU - Patton, Chandler

AU - Zanni, Robert

AU - Atlas, Arthur

AU - Turcios, Nelson

AU - Laraya-Cuasay, Lourdes

AU - Bisberg, Dorothy

AU - Aguila, Helen

AU - Allen, Sarah

AU - James, David

AU - Perkett, Elizabeth

AU - Thompson, Marsha

AU - Budhecha, Sonia

AU - Diaz, Ruben

AU - Rosen, Jonathan

AU - Kaslovsky, Robert

AU - Percciacante, Ronald

AU - Borowitz, Drucy

AU - Cronin, Joseph

AU - McMahon, Colin

AU - Quittell, Lynne

AU - Giusti, Robert

AU - Cohen, Rubin

AU - Decelie-Germana, Joan

AU - Gorvoy, Jack

AU - Patel, Kalpan

AU - Kattan, Meyer

AU - Dozor, Allen

AU - Dimango, Emily

AU - Berdella, Maria

AU - Anbar, Ran

AU - Ianuzzi, Debra

AU - Sexton, James

AU - Tayag-Kier, Catherine

AU - McBride, John

AU - Voter, Karen

AU - Dimaio, Mary

AU - Georgitis, John

AU - Majure, Joseph Marc

AU - Martinez, Maria

AU - McIntosh, Clarke

AU - Leigh, Margaret

AU - Black, Hugh

AU - Hughes, James

AU - Kantak, Anand

AU - Wilmott, Robert

AU - Omlor, Gregory

AU - Stone, Robert

AU - McCoy, Karen

AU - Acton, James

AU - Doershuk, Carl

AU - Fink, Robert

AU - Steffan, Michael

AU - Vauthy, Pierre

AU - Joseph, Patricia

AU - Reyes, Santiago

AU - Kramer, John

AU - Royall, James

AU - Eisenberg, Jay

AU - Wall, Michael

AU - Fiel, Stanley

AU - Scanlin, Thomas

AU - Phadke, Shroti

AU - Weinberg, Joel

AU - Sexauer, William

AU - Wolf, Stephen

AU - Holsclaw, Douglas

AU - Klein, Debra

AU - Warren, Stuart

AU - Kinsey, Robert

AU - Perez, Carlos

AU - Ganeshanathan, Muttiah

AU - Shinnick, James

AU - Panitch, Howard

AU - Varlotta, Laurie

AU - Robinson, Cynthia

AU - Santana, Jose Rodriguez

AU - Passero, Mary Ann

AU - Gwinn, Jane

AU - Baker, Robert

AU - Bowman, Michael

AU - Flume, Patrick

AU - Brown, Daniel

AU - Marville, Roxanne

AU - Wallace, James

AU - Parry, Rodney

AU - Ellenburg, Don

AU - Rogers, John

AU - Mohon, Ricky

AU - Ledbetter, Joel

AU - Hanissian, Aram

AU - Schoumacher, Robert

AU - Campbell, Preston

AU - Harris, Christopher

AU - Slovis, Bonnie

AU - Stokes, Dennis

AU - Hale, Kathryn

AU - Katz, Marcia

AU - Seilheimer, Dan

AU - Sockrider, Marianne

AU - Frank, Allan

AU - Daniel, James

AU - Cunningham, James

AU - Browning, Iley

AU - Bray, John

AU - Dove, Amanda

AU - Mandujano, Fernando

AU - Tremper, Larry

AU - Morse, Martha

AU - Willey-Courand, Donna

AU - Copenhaver, Steven

AU - Pohl, John

AU - McWilliams, Bennie

AU - Martine-Logvinoff, Marie

AU - Wallace, Marsh

AU - Klein, Robert

AU - Amaro, Rodolfo

AU - Couch, Leslie

AU - Brown, Michael

AU - Prestidge, Claude

AU - Inscore, Stephen

AU - Lipton, Andrew

AU - Chatfield, Barbara

AU - Liou, Theodore

AU - Marshall, Bruce

AU - Lahiri, Thomas

AU - Swartz, Donald

AU - Whittaker, Laurie

AU - Karlson, Karl

AU - Ropoll, Ignacio

AU - Rubio, Thomas

AU - Schmidt, Joel

AU - Thomas, David

AU - Osborn, John

AU - Froh, Deborah

AU - Gaston, Benjamin

AU - Elliott, Greg

AU - Gibson, Ronald

AU - Ramsey, Bonnie

AU - McCarthy, Michael

AU - Larson, Lawrence

AU - Ricker, David

AU - Robbins, Mark

AU - Aitken, Moira

AU - Emerson, Julia

AU - Aronoff, Stephen

AU - Moffett, Kathryn

AU - Biller, Julie

AU - Splaingard, Mark

AU - Sullivan, Bradley

AU - Pritchard, Paul

AU - Adair, Stu

AU - Holzwarth, Peter

AU - Dopico, Guillermo

AU - Meyer, Keith

AU - Green, Christopher

AU - Rock, Michael

PY - 2016/2/1

Y1 - 2016/2/1

N2 - Objective To evaluate several alternative measures of forced expiratory volume in 1 second percent predicted (FEV1 %pred) variability as potential predictors of future FEV1 %pred decline in patients with cystic fibrosis. Study design We included 13 827 patients age ≥6 years from the Epidemiologic Study of Cystic Fibrosis 1994-2002 with ≥4 FEV1 %pred measurements spanning ≥366 days in both a 2-year baseline period and a 2-year follow-up period. We predicted change from best baseline FEV1 %pred to best follow-up FEV1 %pred and change from baseline to best in the second follow-up year by using multivariable regression stratified by 4 lung-disease stages. We assessed 5 measures of variability (some as deviations from the best and some as deviations from the trend line) both alone and after controlling for demographic and clinical factors and for the slope and level of FEV1 %pred. Results All 5 measures of FEV1 %pred variability were predictive, but the strongest predictor was median deviation from the best FEV1 %pred in the baseline period. The contribution to explanatory power (R2) was substantial and exceeded the total contribution of all other factors excluding the FEV1 %pred rate of decline. Adding the other variability measures provided minimal additional value. Conclusions Median deviation from the best FEV1 %pred is a simple metric that markedly improves prediction of FEV1 %pred decline even after the inclusion of demographic and clinical characteristics and the FEV1 %pred rate of decline. The routine calculation of this variability measure could allow clinicians to better identify patients at risk and therefore in need of increased intervention.

AB - Objective To evaluate several alternative measures of forced expiratory volume in 1 second percent predicted (FEV1 %pred) variability as potential predictors of future FEV1 %pred decline in patients with cystic fibrosis. Study design We included 13 827 patients age ≥6 years from the Epidemiologic Study of Cystic Fibrosis 1994-2002 with ≥4 FEV1 %pred measurements spanning ≥366 days in both a 2-year baseline period and a 2-year follow-up period. We predicted change from best baseline FEV1 %pred to best follow-up FEV1 %pred and change from baseline to best in the second follow-up year by using multivariable regression stratified by 4 lung-disease stages. We assessed 5 measures of variability (some as deviations from the best and some as deviations from the trend line) both alone and after controlling for demographic and clinical factors and for the slope and level of FEV1 %pred. Results All 5 measures of FEV1 %pred variability were predictive, but the strongest predictor was median deviation from the best FEV1 %pred in the baseline period. The contribution to explanatory power (R2) was substantial and exceeded the total contribution of all other factors excluding the FEV1 %pred rate of decline. Adding the other variability measures provided minimal additional value. Conclusions Median deviation from the best FEV1 %pred is a simple metric that markedly improves prediction of FEV1 %pred decline even after the inclusion of demographic and clinical characteristics and the FEV1 %pred rate of decline. The routine calculation of this variability measure could allow clinicians to better identify patients at risk and therefore in need of increased intervention.

KW - %pred Percent predicted

KW - CF Cystic fibrosis

KW - FEV Forced expiratory volume in 1 second

UR - http://www.scopus.com/inward/record.url?scp=84959338703&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84959338703&partnerID=8YFLogxK

U2 - 10.1016/j.jpeds.2015.08.042

DO - 10.1016/j.jpeds.2015.08.042

M3 - Article

VL - 169

SP - 116-121e6

JO - Journal of Pediatrics

JF - Journal of Pediatrics

SN - 0022-3476

ER -