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- Title
Comparison of New Spirometry Measures to Diagnose COPD.
- Authors
Moreno Giraldo, Angélica M.; Giraldo Cadavid, Luis F.; Botero Rosas, Daniel; Tuta Quintero, Eduardo; Maldonado-Franco, Adriana; Aponte Murcia, Hermencia C.; Avellaneda Suarez, Carlos E.; Morales Cely, Lina María; Bastidas, Alirio Rodrigo
- Abstract
BACKGROUND: COPD is diagnosed by using FEV1FVC, which has limitations as a diagnostic test. We assessed the validity of several measures derived from the expiratory phase of the flow-volume curve obtained from spirometry to diagnose COPD: the slopes that correspond to the volume expired after the 50% and 75% of the FVC, the slope formed between the peak expiratory flow (PEF) and the FVC, and the area under the expiratory flow/volume curve. METHODS: We conducted a cross-sectional diagnostic test study in 765 consecutive subjects referred for spirometry because of respiratory symptoms. We compared the reproducibility and accuracy of the proposed measures against post-bronchodilator FEV1/FVC < 0.70. We also evaluated the proportion of respiratory symptoms for the FEV1/FVC, FEV1 per FEV in the first 6 s (FEV6), and the PEF slope. RESULTS: The subjects had a mean age of 65.8 y, 57% were women, and 35% had COPD. The test-retest intraclass correlation coefficient values were 0.89, 0.85, and 0.83 for FEV1/FVC, FEV1/FEV6, and the PEF slope, respectively. The area under the curve values were 0.93 (expiratory flow/volume), 0.96 (potential expiratory flow/volume), 0.97 (potential expiratory flow/volume at 75% of FVC), and 0.82 (potential expiratory flow/volume at 50% of FVC). The area under the receiver operating characteristic curve was 0.99 for FEV1/FEV6, 0.99 for the slope at 50% of the FVC, and 0.98 for the PEF slope. CONCLUSIONS: The FEV1/FEV6, PEF slope, and 50% FVC slopes had similar diagnostic performances compared with FEV1/FVC.
- Subjects
OBSTRUCTIVE lung disease diagnosis; STATISTICS; CONFIDENCE intervals; CROSS-sectional method; REGRESSION analysis; MANN Whitney U Test; VITAL capacity (Respiration); FORCED expiratory volume; INTRACLASS correlation; QUESTIONNAIRES; DESCRIPTIVE statistics; CHI-squared test; SPIROMETRY; RECEIVER operating characteristic curves; DATA analysis software; SENSITIVITY &; specificity (Statistics); DATA analysis
- Publication
Respiratory Care, 2023, Vol 68, Issue 3, p366
- ISSN
0020-1324
- Publication type
Article
- DOI
10.4187/respcare.10191