Defining and grading an obstructive ventilatory defect (OVD) in 2018

Kammoun, Rim; Sayhi, A.; Ghannouchi, I.; Slama, Souhail; Sayah, M M Ben; Salem, H. Ben; Saad, Mohamed Ben; Tlili, M. S.; Saad, Helmi Ben

doi:10.1183/13993003.congress-2018.pa2408

Cited by 1 publication

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“…In 2005, the ATS/ERS have recommended the use of Lower Limit of Normal (LLN) in interpreting spirometry which is defined as the 5th percentile of a normal population [6]. In practice, the LLN of each spirometric data is obtained by the subtraction of '1.64 × residual standard deviation (SD)' from the predicted value [7]. In fact, an Obstructive Ventilatory Impairment (OVI) is defined when FEV1/FVC ratio is under the LLN.…”

Section: Introductionmentioning

confidence: 99%

Defining and Grading an Obstructive Ventilatory Impairment: American Thoracic Society/ European Respiratory Society Interpretive Strategies of 2005 Versus 2022

Barkous,

Kchaou,

Briki

et al. 2024

AJMAH

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Background: The American Thoracic Society (ATS) and the European Respiratory Society (ERS) have issued several updates to their guidelines for lung function testing between 2005 and 2022. Objective: We aimed to compare ATS/ERS recommendations for 2005(R1) and 2022(R2) in defining Obstructive Ventilatory Impairment (OVI) and in classifying its severity. Patients and Methods: It was a retrospective comparative study including 1129 patients. All patients underwent spirometry with measurement of Forced Expiratory Volume in 1 second (FEV1) and Forced Vital Capacity (FVC). An OVI was considered according to R1 when FEV1/FVC ratio is under the Lower Limit of Normal (LLN) and when the z-score of FEV1/FVC ratio is under -1.645 according to R2. For the severity levels of airflow obstruction: ATS/ERS previously recommended the use of percent predicted FEV1 with 5 levels using cut values of 70%, 60%, 50% and 35%. Recently updated for z-scores with cut values of -2, -2.5 and -4. Mean age was 54.23±19.23 years. Results: For defining an OVI, both definitions were comparable (529 patients with OVI). For the severity classification, the following proportions were assessed: 151 mild, 86 moderate,84 moderately severe, 133 severe and 75 very severe vs 148 mild, 238 moderate, 76 severe and 67 cases having a normal FEV1 (z-score of FEV1 above -1.645), which were classified as mild according to R1. Mild OVI(R2) were distributed according to R1 into 74 mild, 51 moderate, 16 moderately severe and 7 severe. Moderate OVI (R2) were dispatched using R1 to 10 mild, 34 moderate, 66 moderately severe, 103 severe and 25 very severe. Severe OVI(R2) were classified as 1 moderate, 2 moderately severe, 23 severe and 50 very severe. Conclusion: ATS/ERS new and previous recommendations seem to be comparable in defining OVI. However, discrepancies were assessed in classifying its severity.

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Section: Introductionmentioning

confidence: 99%