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Restrictive spirometric pattern and true pulmonary restriction in a general population sample aged 50 - 64 years
BACKGROUND: There is low diagnostic accuracy of the proxy restrictive spirometric pattern (RSP) to identify true pulmonary restriction. This knowledge is based on patients referred for spirometry and total lung volume determination by plethysmograpy, single breath nitrogen washout technique or gas d...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7045734/ https://www.ncbi.nlm.nih.gov/pubmed/32106839 http://dx.doi.org/10.1186/s12890-020-1096-z |
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author | Torén, Kjell Schiöler, Linus Brisman, Jonas Malinovschi, Andrei Olin, Anna-Carin Bergström, Göran Bake, Björn |
author_facet | Torén, Kjell Schiöler, Linus Brisman, Jonas Malinovschi, Andrei Olin, Anna-Carin Bergström, Göran Bake, Björn |
author_sort | Torén, Kjell |
collection | PubMed |
description | BACKGROUND: There is low diagnostic accuracy of the proxy restrictive spirometric pattern (RSP) to identify true pulmonary restriction. This knowledge is based on patients referred for spirometry and total lung volume determination by plethysmograpy, single breath nitrogen washout technique or gas dilution and selected controls. There is, however, a lack of data from general populations analyzing whether RSP is a valid proxy for true pulmonary restriction. We have validated RSP in relation to true pulmonary restriction in a general population where we have access to measurements of total lung capacity (TLC) and spirometry. METHODS: The data was from the Swedish CArdioPulmonary bioImage Study (SCAPIS Pilot), a general population-based study, comprising 983 adults aged 50–64. All subjects answered a respiratory questionnaire. Forced expiratory volume in 1 s (FEV(1)) and forced vital capacity (FVC) were obtained before and after bronchodilation. TLC and residual volume (RV) was recorded using a body plethysmograph. All lung function values are generally expressed as percent predicted (% predicted) or in relation to lower limits of normal (LLN). True pulmonary restriction was defined as TLC < LLN(5) defined as a Z score < − 1.645, i e the fifth percentile. RSP was defined as FEV(1)/FVC ≥ LLN and FVC < LLN after bronchodilation. Specificity, sensitivity, positive and negative likelihood ratios were calculated, and 95% confidence intervals (CIs) were calculated. RESULTS: The prevalence of true pulmonary restriction was 5.4%, and the prevalence of RSP was 3.4%. The sensitivity of RSP to identify true pulmonary restriction was 0.34 (0.20–0.46), the corresponding specificity was 0.98 (0.97–0.99), and the positive likelihood ratio was 21.1 (11.3–39.4) and the negative likelihood ratio was 0.67 (0.55–0.81). CONCLUSIONS: RSP has low accuracy for identifying true pulmonary restriction. The results support previous observations that RSP is useful for ruling out true pulmonary restriction. |
format | Online Article Text |
id | pubmed-7045734 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-70457342020-03-03 Restrictive spirometric pattern and true pulmonary restriction in a general population sample aged 50 - 64 years Torén, Kjell Schiöler, Linus Brisman, Jonas Malinovschi, Andrei Olin, Anna-Carin Bergström, Göran Bake, Björn BMC Pulm Med Research Article BACKGROUND: There is low diagnostic accuracy of the proxy restrictive spirometric pattern (RSP) to identify true pulmonary restriction. This knowledge is based on patients referred for spirometry and total lung volume determination by plethysmograpy, single breath nitrogen washout technique or gas dilution and selected controls. There is, however, a lack of data from general populations analyzing whether RSP is a valid proxy for true pulmonary restriction. We have validated RSP in relation to true pulmonary restriction in a general population where we have access to measurements of total lung capacity (TLC) and spirometry. METHODS: The data was from the Swedish CArdioPulmonary bioImage Study (SCAPIS Pilot), a general population-based study, comprising 983 adults aged 50–64. All subjects answered a respiratory questionnaire. Forced expiratory volume in 1 s (FEV(1)) and forced vital capacity (FVC) were obtained before and after bronchodilation. TLC and residual volume (RV) was recorded using a body plethysmograph. All lung function values are generally expressed as percent predicted (% predicted) or in relation to lower limits of normal (LLN). True pulmonary restriction was defined as TLC < LLN(5) defined as a Z score < − 1.645, i e the fifth percentile. RSP was defined as FEV(1)/FVC ≥ LLN and FVC < LLN after bronchodilation. Specificity, sensitivity, positive and negative likelihood ratios were calculated, and 95% confidence intervals (CIs) were calculated. RESULTS: The prevalence of true pulmonary restriction was 5.4%, and the prevalence of RSP was 3.4%. The sensitivity of RSP to identify true pulmonary restriction was 0.34 (0.20–0.46), the corresponding specificity was 0.98 (0.97–0.99), and the positive likelihood ratio was 21.1 (11.3–39.4) and the negative likelihood ratio was 0.67 (0.55–0.81). CONCLUSIONS: RSP has low accuracy for identifying true pulmonary restriction. The results support previous observations that RSP is useful for ruling out true pulmonary restriction. BioMed Central 2020-02-27 /pmc/articles/PMC7045734/ /pubmed/32106839 http://dx.doi.org/10.1186/s12890-020-1096-z Text en © The Author(s). 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Article Torén, Kjell Schiöler, Linus Brisman, Jonas Malinovschi, Andrei Olin, Anna-Carin Bergström, Göran Bake, Björn Restrictive spirometric pattern and true pulmonary restriction in a general population sample aged 50 - 64 years |
title | Restrictive spirometric pattern and true pulmonary restriction in a general population sample aged 50 - 64 years |
title_full | Restrictive spirometric pattern and true pulmonary restriction in a general population sample aged 50 - 64 years |
title_fullStr | Restrictive spirometric pattern and true pulmonary restriction in a general population sample aged 50 - 64 years |
title_full_unstemmed | Restrictive spirometric pattern and true pulmonary restriction in a general population sample aged 50 - 64 years |
title_short | Restrictive spirometric pattern and true pulmonary restriction in a general population sample aged 50 - 64 years |
title_sort | restrictive spirometric pattern and true pulmonary restriction in a general population sample aged 50 - 64 years |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7045734/ https://www.ncbi.nlm.nih.gov/pubmed/32106839 http://dx.doi.org/10.1186/s12890-020-1096-z |
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