FEV3, FEV6 and their derivatives for detecting airflow obstruction in adult Chinese
Abstract:BACKGROUND: Forced expiratory volume in 3 seconds (FEV3) and 6 seconds (FEV6) could complement FEV1 and forced vital capacity (FVC) for detecting airflow obstruction.
OBJECTIVE: To compare FEV1/ FEV6 and FEV3/FVC with FEV1/FVC in the detection of airflow obstruction.
METHOD: Previous lung function data were re-analysed to establish reference values for FEV3 and FEV6. Data from a separate cohort of male smokers were used as test set. FEV1, FEV3, FEV6, FVC, FEV1/FVC, FEV1/ FEV6 and FEV3/FVC were regressed against age, standing height, weight and body mass index, and the mean and 95% confidence intervals for the lower limit of normal (LLN) values for these parameters were determined.
RESULTS: The percentage of smokers with airflow obstruction in the test population using FEV1/FVC < LLN was 15.0%, while using FEV1/ FEV6 < LLN and FEV3/FVC < LLN they were respectively 18.5% and 18.1%. Using FEV1/FVC < LLN as reference, the sensitivity and specificity of FEV1/ FEV6 < LLN in identifying airflow obstruction were 82.3% and 92.8%, while those for FEV3/FVC < LLN were 78.5% and 92.6%; the positive and negative predictive values were 67% and 96.7% for FEV1/ FEV6 < LLN and 65.3% and 96% for FEV3/FVC < LLN.
CONCLUSION: FEV3/FVC < LLN and FEV1/ FEV6 < LLN are comparable to FEV1/FVC < LLN for detecting airflow obstruction. FEV3/FVC < LLN could be useful in screening for airflow obstruction, while FEV1/ FEV6 < LLN is useful in detecting airflow limitation in the elderly or in subjects with severe airflow obstruction.
Document Type: Research Article
Affiliations: 1: Department of Medicine, University of Hong Kong, Hong Kong, China 2: School of Nursing, University of Hong Kong, Hong Kong, China 3: Department of Medicine and Geriatrics, Princess Margaret Hospital, Hong Kong, China 4: Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong, China 5: Department of Intensive Care, Pamela Youde Nethersole Eastern Hospital, Hong Kong, China 6: Department of Medicine, Queen Elizabeth Hospital, Hong Kong, China 7: Department of Medicine, North District Hospital, Hong Kong, China 8: Respiratory Medicine Department, Kowloon Hospital, Kowloon, Hong Kong, China 9: Department of Medicine and Geriatrics, Tuen Mun Hospital, Hong Kong Special Administrative Region, China
Publication date: May 1, 2012
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