Differences between FEV6, FVC and VC at the diagnosis of obstructive ventilatory defect

Detalhes bibliográficos
Autor(a) principal: Sousa, C.S.
Data de Publicação: 2022
Outros Autores: Coelho, D.B., Amorim, P., Viana, P., Cruz-Martins, N., Drummond, M.
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: http://hdl.handle.net/10400.26/38686
Resumo: Introduction: The diagnosis of airway obstruction can be made through FEV1/FVC ratio <0.7 or FEV1/VC ratio < lower limit of normality (LLN). Several authors advocate that FEV1/FEV6 ratio is an alternative to diagnosing obstructive ventilatory defect, while others have determined that the best cut-off for this ratio (best combined sensitivity and specificity) is 0.73. Objective: To evaluate the non-inferiority of FEV1/FEV6 ratio < 0.73 when compared to FEV1/ FVC ratio < 0.7 and FEV1/VC < LLN in diagnosing airway obstruction. Methods: A retrospective analysis of the medical records from patients who underwent spirometry or plethysmography in a university central hospital from June 1st to December 31st, 2018 was carried out. Only medical records which included FEV1/FVC < 0.7 or FEV1/VC < LLN were selected, and these results were compared to FEV1/FEV6 ratio. Results: A total of 526 patients with obstructive ventilatory defect were identified by one of the two ratios described. Of these, 95.1%, 87.4% and 88.6% were obstructive by FEV1/FVC, FEV1/ VC, and FEV1/FEV6 ratio, respectively. The positive predictive value (PPV) of FEV1/FEV6 in relation to FEV1/FVC ratio was 99.6% (p < 0.001) with a diagnostic efficacy of 92.8%, whereas the PPV of FEV1/FEV6 in relation to FEV1/VC was 91.0% (p < 0.001) and diagnostic efficacy was 85.2%. Most false negatives, comparing FEV6 with the other two tests, were found in patients with FEV1 > 70% (mild obstruction) and in individuals aged >50 years. Conclusions: FEV1/FEV6 < 0.73 may be a good alternative ratio, as it is non-inferior to FEV1/VC and FEV1/FVC in diagnosing obstructive ventilatory defect.
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spelling Differences between FEV6, FVC and VC at the diagnosis of obstructive ventilatory defectobstructive ventilatory defectpulmonary diseaseairway obstructionFEV1/FVCFEV1/VCPortugalMadeira IslandIntroduction: The diagnosis of airway obstruction can be made through FEV1/FVC ratio <0.7 or FEV1/VC ratio < lower limit of normality (LLN). Several authors advocate that FEV1/FEV6 ratio is an alternative to diagnosing obstructive ventilatory defect, while others have determined that the best cut-off for this ratio (best combined sensitivity and specificity) is 0.73. Objective: To evaluate the non-inferiority of FEV1/FEV6 ratio < 0.73 when compared to FEV1/ FVC ratio < 0.7 and FEV1/VC < LLN in diagnosing airway obstruction. Methods: A retrospective analysis of the medical records from patients who underwent spirometry or plethysmography in a university central hospital from June 1st to December 31st, 2018 was carried out. Only medical records which included FEV1/FVC < 0.7 or FEV1/VC < LLN were selected, and these results were compared to FEV1/FEV6 ratio. Results: A total of 526 patients with obstructive ventilatory defect were identified by one of the two ratios described. Of these, 95.1%, 87.4% and 88.6% were obstructive by FEV1/FVC, FEV1/ VC, and FEV1/FEV6 ratio, respectively. The positive predictive value (PPV) of FEV1/FEV6 in relation to FEV1/FVC ratio was 99.6% (p < 0.001) with a diagnostic efficacy of 92.8%, whereas the PPV of FEV1/FEV6 in relation to FEV1/VC was 91.0% (p < 0.001) and diagnostic efficacy was 85.2%. Most false negatives, comparing FEV6 with the other two tests, were found in patients with FEV1 > 70% (mild obstruction) and in individuals aged >50 years. Conclusions: FEV1/FEV6 < 0.73 may be a good alternative ratio, as it is non-inferior to FEV1/VC and FEV1/FVC in diagnosing obstructive ventilatory defect.2021 Sociedade Portuguesa de Pneumologia. Elsevier España, S.L.U.Repositório ComumSousa, C.S.Coelho, D.B.Amorim, P.Viana, P.Cruz-Martins, N.Drummond, M.2022-01-06T17:49:35Z2022-012022-01-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10400.26/38686engC.S. Sousa, D.B. Coelho, P. Amorim et al., Differences between FEV6, FVC and VC at the VC diagnosis of obstructive ventilatory defect,Pulmonology (2021), https://doi.org/10.1016/j.pulmoe.2021.11.0080903-193610.1016/j.pulmoe.2021.11.008info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2023-11-10T02:18:56Zoai:comum.rcaap.pt:10400.26/38686Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T22:34:37.084104Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Differences between FEV6, FVC and VC at the diagnosis of obstructive ventilatory defect
title Differences between FEV6, FVC and VC at the diagnosis of obstructive ventilatory defect
spellingShingle Differences between FEV6, FVC and VC at the diagnosis of obstructive ventilatory defect
Sousa, C.S.
obstructive ventilatory defect
pulmonary disease
airway obstruction
FEV1/FVC
FEV1/VC
Portugal
Madeira Island
title_short Differences between FEV6, FVC and VC at the diagnosis of obstructive ventilatory defect
title_full Differences between FEV6, FVC and VC at the diagnosis of obstructive ventilatory defect
title_fullStr Differences between FEV6, FVC and VC at the diagnosis of obstructive ventilatory defect
title_full_unstemmed Differences between FEV6, FVC and VC at the diagnosis of obstructive ventilatory defect
title_sort Differences between FEV6, FVC and VC at the diagnosis of obstructive ventilatory defect
author Sousa, C.S.
author_facet Sousa, C.S.
Coelho, D.B.
Amorim, P.
Viana, P.
Cruz-Martins, N.
Drummond, M.
author_role author
author2 Coelho, D.B.
Amorim, P.
Viana, P.
Cruz-Martins, N.
Drummond, M.
author2_role author
author
author
author
author
dc.contributor.none.fl_str_mv Repositório Comum
dc.contributor.author.fl_str_mv Sousa, C.S.
Coelho, D.B.
Amorim, P.
Viana, P.
Cruz-Martins, N.
Drummond, M.
dc.subject.por.fl_str_mv obstructive ventilatory defect
pulmonary disease
airway obstruction
FEV1/FVC
FEV1/VC
Portugal
Madeira Island
topic obstructive ventilatory defect
pulmonary disease
airway obstruction
FEV1/FVC
FEV1/VC
Portugal
Madeira Island
description Introduction: The diagnosis of airway obstruction can be made through FEV1/FVC ratio <0.7 or FEV1/VC ratio < lower limit of normality (LLN). Several authors advocate that FEV1/FEV6 ratio is an alternative to diagnosing obstructive ventilatory defect, while others have determined that the best cut-off for this ratio (best combined sensitivity and specificity) is 0.73. Objective: To evaluate the non-inferiority of FEV1/FEV6 ratio < 0.73 when compared to FEV1/ FVC ratio < 0.7 and FEV1/VC < LLN in diagnosing airway obstruction. Methods: A retrospective analysis of the medical records from patients who underwent spirometry or plethysmography in a university central hospital from June 1st to December 31st, 2018 was carried out. Only medical records which included FEV1/FVC < 0.7 or FEV1/VC < LLN were selected, and these results were compared to FEV1/FEV6 ratio. Results: A total of 526 patients with obstructive ventilatory defect were identified by one of the two ratios described. Of these, 95.1%, 87.4% and 88.6% were obstructive by FEV1/FVC, FEV1/ VC, and FEV1/FEV6 ratio, respectively. The positive predictive value (PPV) of FEV1/FEV6 in relation to FEV1/FVC ratio was 99.6% (p < 0.001) with a diagnostic efficacy of 92.8%, whereas the PPV of FEV1/FEV6 in relation to FEV1/VC was 91.0% (p < 0.001) and diagnostic efficacy was 85.2%. Most false negatives, comparing FEV6 with the other two tests, were found in patients with FEV1 > 70% (mild obstruction) and in individuals aged >50 years. Conclusions: FEV1/FEV6 < 0.73 may be a good alternative ratio, as it is non-inferior to FEV1/VC and FEV1/FVC in diagnosing obstructive ventilatory defect.
publishDate 2022
dc.date.none.fl_str_mv 2022-01-06T17:49:35Z
2022-01
2022-01-01T00:00:00Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://hdl.handle.net/10400.26/38686
url http://hdl.handle.net/10400.26/38686
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv C.S. Sousa, D.B. Coelho, P. Amorim et al., Differences between FEV6, FVC and VC at the VC diagnosis of obstructive ventilatory defect,Pulmonology (2021), https://doi.org/10.1016/j.pulmoe.2021.11.008
0903-1936
10.1016/j.pulmoe.2021.11.008
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv 2021 Sociedade Portuguesa de Pneumologia. Elsevier España, S.L.U.
publisher.none.fl_str_mv 2021 Sociedade Portuguesa de Pneumologia. Elsevier España, S.L.U.
dc.source.none.fl_str_mv reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron:RCAAP
instname_str Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron_str RCAAP
institution RCAAP
reponame_str Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
collection Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
repository.name.fl_str_mv Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
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