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Cut-off value of FEV(1)/FEV(6) as a surrogate for FEV(1)/FVC for detecting airway obstruction in a Korean population
BACKGROUND: Forced expiratory volume in 1 second (FEV(1))/forced expiratory volume in 6 seconds (FEV(6)) has been proposed as an alternative to FEV(1)/forced vital capacity (FVC) for detecting airway obstruction. A fixed cut-off value for FEV(1)/FEV(6) in a Korean population is lacking. We investiga...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Dove Medical Press
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4998021/ https://www.ncbi.nlm.nih.gov/pubmed/27578970 http://dx.doi.org/10.2147/COPD.S113568 |
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author | Chung, Kyung Soo Jung, Ji Ye Park, Moo Suk Kim, Young Sam Kim, Se Kyu Chang, Joon Song, Joo Han |
author_facet | Chung, Kyung Soo Jung, Ji Ye Park, Moo Suk Kim, Young Sam Kim, Se Kyu Chang, Joon Song, Joo Han |
author_sort | Chung, Kyung Soo |
collection | PubMed |
description | BACKGROUND: Forced expiratory volume in 1 second (FEV(1))/forced expiratory volume in 6 seconds (FEV(6)) has been proposed as an alternative to FEV(1)/forced vital capacity (FVC) for detecting airway obstruction. A fixed cut-off value for FEV(1)/FEV(6) in a Korean population is lacking. We investigated a fixed cut-off for FEV(1)/FEV(6) as a surrogate for FEV(1)/FVC for detecting airway obstruction. MATERIALS AND METHODS: We used data obtained in the 5 years of the Fifth and Sixth Korean National Health and Nutrition Examination Survey. A total of 14,978 participants aged ≥40 years who underwent spirometry adequately were the study cohort. “Airway obstruction” was a fixed cut-off FEV(1)/FVC <70% according to the Global Initiative for Chronic Obstructive Lung Disease guidelines. We also used European Respiratory Society/Global Lung Initiative 2012 equations for the FEV(1)/FVC lower limit of normal. RESULTS: Among the 14,978 participants (43.5% male, 56.5% female; mean age: 56.9 years for men and 57.0 years for women), 14.0% had obstructive lung function according to a fixed cut-off FEV(1)/FVC <70%. Optimal FEV(1)/FEV(6) cut-off for predicting FEV(1)/FVC <70% was 75% using receiver operating characteristic curve analyses (area under receiver operating characteristic curve =0.989, 95% confidence interval 0.987–0.990). This fixed cut-off of FEV(1)/FEV(6) showed 93.8% sensitivity, 94.8% specificity, 74.7% positive predictive value, 98.9% negative predictive value, and 0.8 Cohen’s kappa coefficient. When compared with FEV(1)/FVC < lower limit of normal, FEV(1)/FEV(6) <75% tended to over-diagnose airflow limitation (just like a fixed cut-off of FEV(1)/FVC <70%). When grouped according to age and FEV(1) (%), FEV(1)/FEV(6) <75% diagnosed more airway obstruction in older participants and mild–moderate stages compared with FEV(1)/FVC <70%. CONCLUSION: A valid fixed cut-off for detecting airway obstruction in a Korean population is FEV(1)/FEV(6) of 75%, but should be used with caution in older individuals and those with mild–moderate airway obstruction. |
format | Online Article Text |
id | pubmed-4998021 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Dove Medical Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-49980212016-08-30 Cut-off value of FEV(1)/FEV(6) as a surrogate for FEV(1)/FVC for detecting airway obstruction in a Korean population Chung, Kyung Soo Jung, Ji Ye Park, Moo Suk Kim, Young Sam Kim, Se Kyu Chang, Joon Song, Joo Han Int J Chron Obstruct Pulmon Dis Original Research BACKGROUND: Forced expiratory volume in 1 second (FEV(1))/forced expiratory volume in 6 seconds (FEV(6)) has been proposed as an alternative to FEV(1)/forced vital capacity (FVC) for detecting airway obstruction. A fixed cut-off value for FEV(1)/FEV(6) in a Korean population is lacking. We investigated a fixed cut-off for FEV(1)/FEV(6) as a surrogate for FEV(1)/FVC for detecting airway obstruction. MATERIALS AND METHODS: We used data obtained in the 5 years of the Fifth and Sixth Korean National Health and Nutrition Examination Survey. A total of 14,978 participants aged ≥40 years who underwent spirometry adequately were the study cohort. “Airway obstruction” was a fixed cut-off FEV(1)/FVC <70% according to the Global Initiative for Chronic Obstructive Lung Disease guidelines. We also used European Respiratory Society/Global Lung Initiative 2012 equations for the FEV(1)/FVC lower limit of normal. RESULTS: Among the 14,978 participants (43.5% male, 56.5% female; mean age: 56.9 years for men and 57.0 years for women), 14.0% had obstructive lung function according to a fixed cut-off FEV(1)/FVC <70%. Optimal FEV(1)/FEV(6) cut-off for predicting FEV(1)/FVC <70% was 75% using receiver operating characteristic curve analyses (area under receiver operating characteristic curve =0.989, 95% confidence interval 0.987–0.990). This fixed cut-off of FEV(1)/FEV(6) showed 93.8% sensitivity, 94.8% specificity, 74.7% positive predictive value, 98.9% negative predictive value, and 0.8 Cohen’s kappa coefficient. When compared with FEV(1)/FVC < lower limit of normal, FEV(1)/FEV(6) <75% tended to over-diagnose airflow limitation (just like a fixed cut-off of FEV(1)/FVC <70%). When grouped according to age and FEV(1) (%), FEV(1)/FEV(6) <75% diagnosed more airway obstruction in older participants and mild–moderate stages compared with FEV(1)/FVC <70%. CONCLUSION: A valid fixed cut-off for detecting airway obstruction in a Korean population is FEV(1)/FEV(6) of 75%, but should be used with caution in older individuals and those with mild–moderate airway obstruction. Dove Medical Press 2016-08-19 /pmc/articles/PMC4998021/ /pubmed/27578970 http://dx.doi.org/10.2147/COPD.S113568 Text en © 2016 Chung et al. This work is published and licensed by Dove Medical Press Limited The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. |
spellingShingle | Original Research Chung, Kyung Soo Jung, Ji Ye Park, Moo Suk Kim, Young Sam Kim, Se Kyu Chang, Joon Song, Joo Han Cut-off value of FEV(1)/FEV(6) as a surrogate for FEV(1)/FVC for detecting airway obstruction in a Korean population |
title | Cut-off value of FEV(1)/FEV(6) as a surrogate for FEV(1)/FVC for detecting airway obstruction in a Korean population |
title_full | Cut-off value of FEV(1)/FEV(6) as a surrogate for FEV(1)/FVC for detecting airway obstruction in a Korean population |
title_fullStr | Cut-off value of FEV(1)/FEV(6) as a surrogate for FEV(1)/FVC for detecting airway obstruction in a Korean population |
title_full_unstemmed | Cut-off value of FEV(1)/FEV(6) as a surrogate for FEV(1)/FVC for detecting airway obstruction in a Korean population |
title_short | Cut-off value of FEV(1)/FEV(6) as a surrogate for FEV(1)/FVC for detecting airway obstruction in a Korean population |
title_sort | cut-off value of fev(1)/fev(6) as a surrogate for fev(1)/fvc for detecting airway obstruction in a korean population |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4998021/ https://www.ncbi.nlm.nih.gov/pubmed/27578970 http://dx.doi.org/10.2147/COPD.S113568 |
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