Efficacy of the FEV1/FEV6 ratio compared to the FEV1/FVC ratio for the diagnosis of airway obstruction in subjects aged 40 years or over

Abstract

The present cross-sectional, population-based study was designed to evaluate the performance of the FEV 1 /FEV 6 ratio for the detection of airway-obstructed subjects compared to the FEV 1 /FVC <0.70 fixed ratio test, as well as the lower limit of normality (LLN) for 1000 subjects ≥40 years of age in the metropolitan area of São Paulo, SP, Brazil. After the exclusion of 37 (3.7%) spirometries, a total of 963 pre-bronchodilator (BD) and 918 post-BD curves were constructed. The majority of the post-BD curves (93.1%) were of very good quality and achieved grade A (762 curves) or B (93 curves). The FEV 1 /FEV 6 and FEV 1 /FVC ratios were highly correlated (r 2 = 0.92, P < 0.000). Two receiver operator characteristic curves were constructed in order to express the imbalance between the sensitivity and specificity of the FEV 1 /FEV 6 ratio compared to two FEV 1 /FVC cut-off points for airway obstruction: equal to 70 (area under the curve = 0.98, P < 0.0001) and the LLN (area under the curve = 0.97, P < 0.0001), in the post-BD curves. According to an FEV 1 /FVC <0.70, the cut-off point for the FEV 1 /FEV 6 ratio with the highest sum for sensitivity and specificity was 0.75. The FEV 1 /FEV 6 ratio can be considered to be a good alternative to the FEV 1 /FVC ratio for the diagnosis of airway obstruction, both using a fixed cut-off point or below the LLN as reference. The FEV 1 /FEV 6 ratio has the additional advantage of being an easier maneuver for the subjects and for the lung function technicians, providing a higher reproducibility than traditional spirometry maneuvers.

Validación de la versión traducida del Chronic Obstructive Pulmonary Disease-Population Screener (COPD-PS). Su utilidad y la del FEV1/FEV6 para el diagnóstico de enfermedad pulmonar obstructiva crónica

“…Para la muestra total, el CCI fue 0,94 con una media en el test de 4,07 (1,60) y en el retest de 4,17 (1,46). Para el subgrupo de 16 controles, el CCI fue 0,89, con una media en el test de 3,31 (1,35) y en el retest de 3,44 (1,26). Para el subgrupo de 14 casos el CCI fue 0,94, con una media en test de 4,93 (1,44) y en el retest de 5,00 (1,24).…”

“…Nuestros resultados indican que un cociente FEV 1 /FEV 6 < 0,75 permite clasificar correctamente al 82,4% de los individuos como portadores de obstrucció n cró nica al flujo aé reo. Este punto de corte es el mismo que recomiendan Rosa et al 26 y está en el intervalo de los distintos estudios (0,70 a 0,76) 7 ; se ha demostrado que valores superiores, como 0,80, no ofrecen una adecuada discriminació n 28 . En resumen, hemos investigado la validez de 2 mé todos distintos para el cribado de EPOC en AP.…”

On-site screening of farming-induced chronic obstructive pulmonary disease with the use of an electronic mini-spirometer: results of a pilot study in Brittany, France

“…The devices have been validated to screen patients for bronchial obstruction in primary care settings (Hankinson et al 2003;Kaufmann et al 2009). The FEV1/FEV6 (forced expiratory volume in 6 s) ratio is nearly as strong an independent predictor of decline in lung function as the FEV1/FVC ratio (Enright et al 2002;Rosa et al 2007). FEV1/FEV6 can be used as a valid alternative to FEV1/ FVC in diagnosing airway obstruction (Collectif Capital Souffle 2007;Jing et al 2009;Lundgren et al 2007).…”

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

“…Melbye et al 20 used a spirometry database of referenced subjects from a medical facility, whereas subjects from a highly homogeneous population-based sample in a northern city of Norway were recruited in the study by Vandevoorde et al 21 A fixed cutoff of 0.75 was obtained from healthy adults in PLATINO studies. 22 In our study, the volunteers are from local communities, and this can reflect actual lung function. Despite the different population backgrounds among these studies, a similar cutoff point for the FEV 1 /FEV 6 ratio was obtained.…”