ArticleChest2026
Intersession Variability in Single-Breath Diffusing Capacity of Carbon Monoxide.
Article in Chest, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
7 authors.
Funding
Abstract
backgroundDiffusing capacity for carbon monoxide (Dlco) is a critical measurement for diagnosing and monitoring cardiorespiratory diseases, but its clinical utility is limited by measurement variability. Clinical guidelines lack evidence-based thresholds for distinguishing significant changes from normal variability. RESEARCH QUESTION: What is the magnitude and determinants of Dlco intersession variability in routine clinical practice, and what evidence-based thresholds can guide interpretation of serial measurements? STUDY DESIGN AND
methodsThis cohort study analyzed data from 5,069 patients with stable spirometry-defined as < 5% change in both FEV
resultsDlco demonstrated substantial intersession variability that exceeded conventional thresholds, with 90th percentile values of 3.5 mL/min/mm Hg (absolute), 15% (percent predicted), and 21% (relative percentage). Higher baseline Dlco, lower hemoglobin, male sex, and restrictive patterns were associated with greater absolute variability, but these factors only explained a fraction of total observed variability (R
interpretationIn this study, Dlco was shown to exhibits substantial intersession variability in clinical settings, exceeding commonly recognized levels. The choice of variability metric influenced how changes are interpreted, especially across different baseline Dlco values. The evidence-based thresholds and 3-tier classification system established in this study provide practical tools for distinguishing clinically significant Dlco changes from normal measurement variability.
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