FEV₁/FEV₆in Primary Care Is a Reliable and Easy Method for the Diagnosis of COPD

Abstract

BACKGROUND: FEV 6 can be used as a convenient alternative to FVC. The aim of this study was to determine an alternative to the fixed cutoff points of FEV 1 /FVC <0.70 suitable for FEV 1 /FEV 6 in primary care. METHODS: Pulmonary function testing was conducted on volunteers recruited from 4 community centers in Xi'an, China, between July and August 2012. Participants underwent 3 FVC maneuvers. The maneuver with the best FEV 1 was retained. FVC, FEV 1 , and FEV 6 were measured by portable spirometer. The receiver operating characteristic curves that corresponded to the optimal combination of sensitivity and specificity for FEV 1 /FEV 6 were determined. A kappa test was used to compare the agreement between FEV 1 /FVC and FEV 1 /FEV 6 . The positive predictive value and negative predictive value were also calculated. RESULTS: A total of 767 volunteers participated in this study, of whom 297 were male and 470 were female. Considering FEV 1 /FVC <0.70 as the accepted standard for COPD, the area under the curve was 98% (P < .001), and the FEV 1 /FEV 6 cutoff, corresponding to the greatest sum of sensitivity and specificity, was 0.72. For the total population, the FEV 1 /FEV 6 sensitivity, specificity, positive predictive value, and negative predictive value were 96.9, 98.8, 95.8, and 99.2%, respectively. The agreement between the 2 cutoff points was excellent, and the kappa value was 0.954. CONCLUSIONS: FEV 1 /FEV 6 <0.72 can be used in primary care as a valid alternative to FEV 1 /FVC <0.70 as a fixed cutoff point for the detection of COPD in adults. This study suggests that FEV 1 /FEV 6 is an effective and well validated option that should be used in primary care to detect COPD, which is a rampant problem. Key words: COPD; forced expiratory volume in six seconds; pulmonary function testing; spirometry. [Respir Care 2016;61(3):349 -353.

Active case finding strategy for chronic obstructive pulmonary disease with handheld spirometry

“…We also tested the validity of a suggested FEV 1 /FEV 6 <0.72 cut-off for airway limitation reported in studies conducted in Japan and China. [ 23 , 24 ] We chose this value among others because of the similar ethnicity between these and our study population, which is an important consideration for evaluating pulmonary function. [ 25 ] Using this cut-off for our study population, sensitivity was 45.5%, specificity was 89.3%, PPV was 57.1%, and NPV was 83.9%.…”

Novel App-Based Portable Spirometer for the Early Detection of COPD

“…These findings are similar to those of the present study. Although FEV 6 is an acceptable surrogate for FVC in spirometry, FEV 6 has some drawbacks, such as the underestimation of mild airway obstruction [ 30 , 31 , 32 ]. Hernández et al reported that FEV 1 /FVC values of <0.7 determined using a smartphone-based spirometer, namely Air-Smart, for detecting obstructive airway diseases had a sensitivity of 94.0% and a specificity of 97.2% [ 20 ].…”

Self-Reported Smoking Status 10-Months After a Single Session Intervention Including an Education Conference About Smoking Harms and Announcement of Spirometric Lung-Age

“…For the cigarette-dependence status, two groups of participants were identified: nondependent (FTCD score ≤ 2) and dependent (FTCD score ≥ 3). For the spirometry test, three spirometric patterns were possible 43 : “no” bronchial obstruction (FEV 1 /FEV 6 ≥ 0.80), “possible” bronchial obstruction (0.70 ≤ FEV 1 /FEV 6 < 0.80) and “most likely” bronchial obstruction (FEV 1 /FEV 6 < 0.70). According to the SLA values, two scenarios arise.…”