Global Lung Function Initiative

About
The Global Lung Function Initiative (GLI) has collected respiratory function outcomes from researchers and health care professionals from around the world. To date, the GLI Network has produced reference equations for Spirometry and Transfer Factor for Carbon Monoxide. Current projects include reference equations for lung volumes.  Data collection for all lung function tests is ongoing, interested groups may submit additional data at any time.  In addition, the GLI database is available to researchers to conduct answer research questions. 
 
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 [+]  PDF journal article, handout or slides GLI Network Terms of Reference
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The GLI Network administers the lung function data repository, whereas the data are securely stored by the European Respiratory Society (ERS). All data are managed and stored according to current international best practice.
 

The GLI team have developed educational materials to help inform health professionals and patients about the GLI equations, and what they can expect when pulmonary function laboratories switch to using the GLI.

 [+]  PDF journal article, handout or slides ERS TASK FORCE REPORT. Multi-ethnic reference values for spirometry for the 3–95-yr age range: the global lung function 2012 equations
Eur Respir J 2012; 40: 1324–1343 See this session or publication
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 [+]  PDF journal article, handout or slides GLI-2012 - Educational Pamphlet for Health Professionals: New recommendations for the interpretation of spirometric lung function measurements
GOSH NHS Foundation Trust March 2013 See this session or publication
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 [+]  PDF journal article, handout or slides GLI-2012 - Educational Pamphlet for Parents and children: New, improved growth charts for lung function
GOSH NHS Foundation Trust March 2013 See this session or publication
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The Quanjer GLI-2012 regression equations for spirometric indices arose from the work of a Task Force of the European Respiratory Society. Their report has been endorsed by the European Respiratory Society (ERS), American Thoracic Society (ATS), Australian and New Zealand Society of Respiratory Science (ANZSRS), Asian Pacific Society for Respirology (APSR), Thoracic Society of Australia and New Zealand (TSANZ) and the American College of Chest Physicians (ACCP).

The GLI Spirometry Task Force derived continuous prediction equations and their lower limits of normal for spirometric indices. Over 160,000 data points from 72 centres in 33 countries were shared with the GLI. Eliminating data that could not be used (mostly missing ethnic group, some outliers) left 97,759 records of healthy nonsmokers (55.3% females) aged 2.5–95 yrs.

Lung function data were collated and prediction equations derived using the LMS method, which allows simultaneous modelling of the mean (mu), the coefficient of variation (sigma) and skewness (lambda) of a distribution family.

Reference equations were derived for healthy individuals aged 3–95 yrs for Caucasians (n=57,395), African–Americans (n=3,545), and North (n=4,992) and South East Asians (n=8,255). Forced expiratory value in 1 s (FEV1) and forced vital capacity (FVC) between ethnic groups differed proportionally from that in Caucasians, such that FEV1/FVC remained virtually independent of ethnic group. For individuals not represented by these four groups, or of mixed ethnic origins, a composite equation taken as the average of the above equations is provided to facilitate interpretation until a more appropriate solution is developed.

The Task Force (Global Lung Function Initiative, GLI) summarised the regression equations and lookup tables, required for implementation into software, in an Excel file. The GLI group also produced tools for calculating predicted values, their lower limits of normal and the z-scores of measured indices, as well as facilities for analysing datasets. The tools are accessible via the menu on the left. By law the use of the GLI software packages is restricted to research, education, training and validation of implementation in software; they are not to be used in patient treatment.