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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...

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Autores principales: Chung, Kyung Soo, Jung, Ji Ye, Park, Moo Suk, Kim, Young Sam, Kim, Se Kyu, Chang, Joon, Song, Joo Han
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove Medical Press 2016
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.
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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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