• Respiratory care · Mar 2023

    Comparison of New Spirometry Measures to Diagnose COPD.

    • Angélica M Moreno Giraldo, CadavidLuis F GiraldoLFGSchool of Medicine, Universidad de La Sabana, Chía, Colombia.Interventional Pulmonology, Fundación Neumológica colombiana, Bogotá, Colombia., RosasDaniel BoteroDBMorphophysiology Department, Universidad de La Sabana, Chía, Colombia., QuinteroEduardo TutaETSchool of Medicine, Universidad de La Sabana, Chía, Colombia., Adriana Maldonado-Franco, MurciaHermencia C AponteHCAInternal Medicine, Clínica Universidad de La Sabana, Chía, Colombia., SuárezCarlos E AvellanedaCEAEconomist, Universidad de Los Andes, Bogotá, Colombia., CelyLina María MoralesLMMSchool of Medicine, Universidad de La Sabana, Chía, Colombia., and Alirio Rodrigo Bastidas.
    • School of Medicine, Universidad de La Sabana, Chía, Colombia.
    • Respir Care. 2023 Mar 1; 68 (3): 366373366-373.

    BackgroundCOPD is diagnosed by using FEV1/FVC, 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.MethodsWe 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.ResultsThe 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.ConclusionsThe FEV1/FEV6, PEF slope, and 50% FVC slopes had similar diagnostic performances compared with FEV1/FVC.Copyright © 2023 by Daedalus Enterprises.

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