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The lung clearance index (LCI) is responsive to acute respiratory events in preschool children with cystic fibrosis (CF) but its' utility to identify and manage these events in school-age children with CF is not well defined. In a multisite prospective observational study, LCI and forced expiratory volume in 1 second (FEV1) were measured quarterly and during acute respiratory events. Linear regression was used to compare relative changes in LCI and FEV1 % predicted at acute respiratory events. Logistic regression was used to compare the