“…The odds ratio for determining that patient had COPD for FEV 1 /FVC was 6.5 when adjusting for age, sex and smoking status. Now this finding is not surprising as this is the major and robust index used to describe COPD, provides external validity and has been commented upon many times in the literature and in this journal [9][10][11]. Next let us consider the intriguing additional benefit of assessing PIF.…”