Limitação ao fluxo aéreo em brasileiros da raça branca: VEF1/VEF6 vs. VEF1/CVF

Soares, André Luis Pinto; Rodrigues, S. C. P.; Pereira, Carlos Alberto de Castro

doi:10.1590/s1806-37132008000700006

Cited by 7 publications

(4 citation statements)

References 15 publications

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“…However, some drawbacks against FEV6 were reported[11–13] and should be kept in mind when FEV6 is used as a screening test for airway obstruction. In patients with obstructive ventilatory diseases, spirometry may not reliably diagnose a concomitant restrictive defect, but it can rule out restriction for patients with FVC or FEV6 >85% predicted in males or >70% predicted in females.…”

Section: Discussionmentioning

confidence: 99%

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Acceptable alternatives for forced vital capacity in the spirometric diagnosis of bronchial asthma

Lutfi

2011

Int J App Basic Med Res

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Background:In patients with advanced obstructive ventilatory disorders, expiration may last for a relatively long time until the end-of-test standards for forced vital capacity (FVC) are satisfied. This may be difficult for both the patient and the technician. The Forced expiratory volume in 3 seconds (FEV3) and Forced expiratory volume in 6 seconds (FEV6) maneuvers are simple, undemanding and easier to perform when compared with FVC; however, their reliability to be used as alternatives for FVC is controversial.Aim:To judge whether FEV3 and FEV6 can be used instead of FVC in detecting airway obstruction in asthmatic patients.Settings and Design:This study was a cross-sectional case–control laboratory-based study.Materials and Methods:The study involved 40 known asthmatic patients and 40 apparently healthy, gender- and age-matched controls. Spirometery was used for assessing pulmonary function according to the American Thoracic Society and European Respiratory Society criteria.Statistical Analysis:A significant difference in the means between the groups was performed using Student's t-test. The receiver operating characteristic (ROC) curves were used to compare efficiency of the studied spirometric measurements on asthma diagnosis.Results:The mean of FEV3 was not significantly different when compared with the mean of FVC (P = 0.352 for asthmatic patients and P = 0.957 for control group). This was also true when the mean of FEV6 was compared with the mean of FVC (P = 0.805 for asthmatic patients and P = 0.957 for control group). The area under the ROC curves of FEV1/FVC%, FEV1/FEV3% and FEV1/FEV6% were also comparable.Conclusion:FEV3 and FEV6 are accurate and reliable alternatives for FVC in assessing airway obstruction of asthmatic patients.

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Section: Discussionmentioning

confidence: 99%

“…[11–13] This controversy could partly be explained by the fact that previous studied examined patients with different pathologies. [7–12] Studies on FEV3 and FEV6 were usually on patients with chronic obstructive lung diseases, smokers or obstructive lung diseases in general without special concern to bronchial asthma.…”

Section: Introductionmentioning

confidence: 99%

Acceptable alternatives for forced vital capacity in the spirometric diagnosis of bronchial asthma

Lutfi

2011

Int J App Basic Med Res

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“…A 6-second spirometry test has been proposed as a simplified alternative to a more prolonged forced vital capacity (FVC) manoeuvre. 11–19 Although current criteria to diagnose airflow obstruction and COPD are based on forced expiratory volume in 1s (FEV 1 )/FVC, FEV 1 /forced expiratory volume in 6s (FEV 6 ) is almost equivalent, simpler, and possibly more specific. 20 Several inexpensive electronic devices (also known as pocket spirometers) measure FEV 1 and FEV 6 , an improvement over PEF measurements.…”

Section: Introductionmentioning

confidence: 99%

Efficient screening for COPD using three steps: a cross-sectional study in Mexico City

Franco‐Marina¹,

Fernández-Plata²,

Torre-Bouscoulet³

et al. 2014

npj Prim Care Resp Med

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Background:Underdiagnosis of chronic obstructive pulmonary disease (COPD) in primary care can be improved by a more efficient screening strategy.Aims:To evaluate a three-step method of screening for COPD consisting of an initial short questionnaire followed by measurement of forced expiratory volume in 1s/forced expiratory volume in 6s (FEV1/FEV6) using an inexpensive pocket spirometer in those with high risk, and diagnostic quality spirometry in those with a low FEV1/FEV6.Methods:We analysed two related Mexico City cross-sectional samples. The 2003 Mexico City PLATINO survey (n=542) was used to develop a short questionnaire to determine the risk of COPD and a 2010 survey (n=737) additionally used a pocket spirometer. The discriminatory power of the two instruments was assessed with receiver operator characteristic (ROC) curves using three COPD definitions.Results:The developed COPD scale included two variables from a simple questionnaire and, in ROC analysis, an area under the curve (AUC) between 0.64 and 0.77 was found to detect COPD. The pocket spirometer had an AUC between 0.85 and 0.88 to detect COPD. Using the COPD scale as a first screening step excluded 35–48% of the total population from further testing at the cost of not detecting 8–18% of those with COPD. Using the pocket spirometer and sending those with a FEV1/FEV6<0.80 for diagnostic quality spirometry is very efficient, and substantially improved the positive predictive value at the cost of not detecting one-third of COPD cases.Conclusions:A three-step screening strategy for COPD substantially reduces the need for spirometry testing when only a COPD scale is used for screening.

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“…Despite this controversy, some reports have argued that FEV 1 /FEV 6 can reduce the sensitivity of detecting airway obstruction, especially in elderly patients with mild airway obstruction 20,21. Therefore, other studies6 have submitted increased cut-off values (73%–76%) of FEV 1 /FEV 6 for detecting airway obstruction to overcome these limitations.…”

Section: Introductionmentioning

confidence: 99%

Cut-off value of FEV1/FEV6 as a surrogate for FEV1/FVC for detecting airway obstruction in a Korean population

Chung

Jung

Park³

et al. 2016

COPD

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Background Forced expiratory volume in 1 second (FEV 1 )/forced expiratory volume in 6 seconds (FEV 6 ) has been proposed as an alternative to FEV 1 /forced vital capacity (FVC) for detecting airway obstruction. A fixed cut-off value for FEV 1 /FEV 6 in a Korean population is lacking. We investigated a fixed cut-off for FEV 1 /FEV 6 as a surrogate for FEV 1 /FVC for detecting airway obstruction. Materials and methods We used data obtained in the 5 years of the Fifth and Sixth Korean National Health and Nutrition Examination Survey. A total of 14,978 participants aged ≥40 years who underwent spirometry adequately were the study cohort. “Airway obstruction” was a fixed cut-off FEV 1 /FVC <70% according to the Global Initiative for Chronic Obstructive Lung Disease guidelines. We also used European Respiratory Society/Global Lung Initiative 2012 equations for the FEV 1 /FVC lower limit of normal. Results Among the 14,978 participants (43.5% male, 56.5% female; mean age: 56.9 years for men and 57.0 years for women), 14.0% had obstructive lung function according to a fixed cut-off FEV 1 /FVC <70%. Optimal FEV 1 /FEV 6 cut-off for predicting FEV 1 /FVC <70% was 75% using receiver operating characteristic curve analyses (area under receiver operating characteristic curve =0.989, 95% confidence interval 0.987–0.990). This fixed cut-off of FEV 1 /FEV 6 showed 93.8% sensitivity, 94.8% specificity, 74.7% positive predictive value, 98.9% negative predictive value, and 0.8 Cohen’s kappa coefficient. When compared with FEV 1 /FVC < lower limit of normal, FEV 1 /FEV 6 <75% tended to over-diagnose airflow limitation (just like a fixed cut-off of FEV 1 /FVC <70%). When grouped according to age and FEV 1 (%), FEV 1 /FEV 6 <75% diagnosed more airway obstruction in older participants and mild–moderate stages compared with FEV 1 /FVC <70%. Conclusion A valid fixed cut-off for detecting airway obstruction in a Korean population is FEV 1 /FEV 6 of 75%, but should be used with caution in older individuals and those with mild–moderate airway obstruction.

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Limitação ao fluxo aéreo em brasileiros da raça branca: VEF1/VEF6 vs. VEF1/CVF

Abstract: The FEV1/FEV6 ratio has poor sensitivity and should not be used to replace the FEV1/FVC ratio in the diagnosis of mild airway obstruction.

Cited by 7 publications

References 15 publications

Acceptable alternatives for forced vital capacity in the spirometric diagnosis of bronchial asthma

Acceptable alternatives for forced vital capacity in the spirometric diagnosis of bronchial asthma

Efficient screening for COPD using three steps: a cross-sectional study in Mexico City

Cut-off value of FEV<sub>1</sub>/FEV<sub>6</sub> as a surrogate for FEV<sub>1</sub>/FVC for detecting airway obstruction in a Korean population

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