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Peak expiratory flow as a screening tool to detect airflow obstruction in a primary health care setting

Authors: Tian, J.1; Zhou, Y.1; Cui, J.1; Wang, D.2; Wang, X.3; Hu, G.1; Tian, Y.1; Jiang, Y.1; Zheng, J.1; Wang, J.4; Zhong, N.1; Ran, P.1

Source: The International Journal of Tuberculosis and Lung Disease, Volume 16, Number 5, 1 May 2012 , pp. 674-680(7)

Publisher: International Union Against Tuberculosis and Lung Disease

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Abstract:

BACKGROUND: Peak expiratory flow (PEF) measurement is less expensive and requires fewer skills than spirometry testing. It is thus expected to be a reasonable substitute for spirometry in airflow obstruction screening when spirometry is unavailable.

OBJECTIVES: To evaluate the validation of PEF measurement in the detection of airflow obstruction using newly established regression equations.

METHODS: The PEFs of 553 ‘normal’ participants aged 40–85 years were measured using mechanical devices. Based on these data, regression equations were generated to predict normal PEF values. Data were then collected from 3379 subjects. The specificity and sensitivity of the different predicted PEF cut-off points for detecting airflow obstruction were evaluated by spirometry, based on previously generated regression equations.

RESULTS: Using newly established reference values for PEF, PEF had higher sensitivity and specificity than the questionnaire in detection of airflow obstruction. That PEF < 80% of predicted was more effective in the detection of airflow obstruction was confirmed by the lower limit of normal of forced expiratory volume in 1 second/forced vital capacity, Global Initiative for Chronic Obstructive Lung Disease (GOLD), and GOLD plus symptom, with a sensitivity of 78.7%, 76.8%, 85.3% and a specificity of 81.9%, 83.8%, 81.4%, respectively.

CONCLUSIONS: Mechanical PEF may be a reasonable method of screening for airflow obstruction in settings where spirometry is unavailable.

Keywords: COPD; PEF; airflow obstruction; screening

Document Type: Research Article

DOI: http://dx.doi.org/10.5588/ijtld.11.0429

Affiliations: 1: State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Diseases, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, China 2: The Second Hospital of Liwan District of Guangzhou, Guangzhou, China 3: The First Municipal Hospital of Shaoguan, Shaoguan, Guangdong, China 4: State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Diseases, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, China; Division of Pulmonary and Critical Care Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA

Publication date: May 1, 2012

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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