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"DLCO (pred adj Hb 13.8 g/dL)" - meaning? #21

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@jamais-vu

In Figure 3 of the ATS's Recommendations for a Standardized Pulmonary Function Report (2017) example PFT, there is a measurement DLCO (pred adj Hb 13.8 g/dL). In the caption for Figure 3, it is stated:

pred adj Hb = hemoglobin adjusted for predicted value

It's unclear to me what this means - is the observed value adjusted for some predicted value of hemoglobin, or is the predicted value adjusted for a hemoglobin value of 13.8 g/dL?

My best guess is it means the predicted value is adjusted for a hemoglobin value of 13.8 g/dL. Note that the provided values for DLCO (at standard PB) and DLCO (pred adj Hb 13.8 g/dL) have equivalent results but different % pred:

DLCO (at standard PB):

  • result = 13.0
  • % pred = 42%

DLCO (pred adj Hb 13.8 g/dL):

  • result = 13.0
  • % pred = 53%

This leads me to believe the predicted value has been adjusted for hemoglobin, and the result value is maybe even the same measurement (ie a duplicate value of the DLCO (at standard PB) result is inserted into the table).

There's a LOINC code for "Diffusion capacity.carbon monoxide adjusted for hemoglobin" which I thought corresponded to this. But that does not seem to apply here if DLCO (pred adj Hb 13.8 g/dL) means the predicted value was adjusted and the result value was not adjusted.

Implications

If my above guess is correct, then our profiles DLCOAdjustedForHemoglobin and DLCOAdjustedForHemoglobin_PercentOfPredicted will need to be updated.

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