Appropriate pediatric spirometry reference equations and interpretation

Spirometry is an important tool in the diagnosis and management of pediatric pulmonary diseases. Reference equations enable the comparison of an individual's lung function to that of a healthy reference population of the same age, sex, height, and race/ethnicity. This comparison is important both in distinguishing health from disease and in monitoring the lung function of a growing child over time. A range of reference equations exist, and no single equation is ideal for all situations. However, there are important considerations to understand when choosing an equation. This article reviews how reference equations are created, how to use them to interpret lung function measurements, and how to choose appropriate reference equations, highlights current limitations, and suggests areas for future research and collaboration.