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BACKGROUND: COPD is diagnosed by using FEV 1 /FVC, which has limitations as a diagnostic test. We assessed the validity of several measures derived from the expiratory phase of the flow-volume curve obtained from spirometry to diagnose COPD: the slopes that correspond to the volume expired after the 50% and 75% of the FVC, the slope formed between the peak expiratory flow (PEF) and the FVC, and the area under the expiratory flow/volume curve. METHODS: We conducted a cross-sectional diagnostic test study in 765 consecutive subjects referred for spirometry because of respiratory symptoms. We compared the reproducibility and accuracy of the proposed measures against post-bronchodilator FEV 1 /FVC < 0.70. We also evaluated the proportion of respiratory symptoms for the FEV 1 /FVC, FEV 1 per FEV in the first 6 s (FEV 6 ), and the PEF slope. RESULTS: The subjects had a mean age of 65.8 y, 57% were women, and 35% had COPD. The testretest intraclass correlation coefficient values were 0.89, 0.85, and 0.83 for FEV 1 /FVC, FEV 1 /FEV 6 , and the PEF slope, respectively. The area under the curve values were 0.93 (expiratory flow/volume), 0.96 (potential expiratory flow/volume), 0.97 (potential expiratory flow/volume at 75% of FVC), and 0.82 (potential expiratory flow/volume at 50% of FVC). The area under the receiver operating characteristic curve was 0.99 for FEV 1 /FEV 6 , 0.99 for the slope at 50% of the FVC, and 0.98 for the PEF slope. CONCLUSIONS: The FEV 1 /FEV 6 , PEF slope, and 50% FVC slopes had similar diagnostic performances compared with FEV 1 /FVC.

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Objectives This study aimed to compare the performance of the CURB-65, A-DROP, and NEWS scores for the prediction of clinical outcomes in patients with community-acquired pneumonia (CAP) in a Colombian population. Materials and Methods In this retrospective cohort study, we analyzed data from patients with CAP seen within the emergency department, general ward hospitalization, and intensive care unit in a tertiary care health institution located in Cundinamarca, from January 2012 to December 2020. Results A total of 1651 patients were included in our study. CURB-65 and A-DROP scores showed a good performance for primary outcomes related to in-hospital mortality and 30-day mortality with an area under the receiver operating characteristic curve (AUC-ROC) of 0.72 (95% confidence interval [CI], 0.69–0.76) and 0.69 (95% CI, 0.65–0.73), respectively. On the other hand, NEWS score exhibited an acceptable performance in predicting in-hospital mortality and 30-day mortality; furthermore, it showed better performance in anticipating the need for invasive mechanical ventilation and vasopressor therapy (AUC-ROC of 0.64 [95% CI, 0.59–0.69] and AUC-ROC of 0.65 [95% CI, 0.60–0.69], respectively). Conclusions Our findings suggest that, in patients with CAP, the use of CURB-65, A-DROP, and NEWS scores helps the clinician to predict in-hospital and 30-day mortality. However, NEWS score proves to be a more convenient tool to predict the need for several life support measures and management in the intensive care unit.