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Allergy and Airway |

Fixed Cut-Off Point of FEV1/FEV6 in the Detection of Airway Obstruction in Korea

HeeJin Park; JuHan Song; YoungSam Kim
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Yonsei University College of Medicine, Seoul, Republic of Korea


Chest. 2014;146(4_MeetingAbstracts):36A. doi:10.1378/chest.1990397
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Abstract

SESSION TITLE: COPD Diagnosis and Evaluation Posters II

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 29, 2014 at 01:30 PM - 02:30 PM

PURPOSE: The aim of this study was to determine cut-off value for forced expiratory volume in one second/forced expiratory volume in six second (FEV1/FEV6) as an alternative for FEV1/forced vital capacity (FVC) in the detection of airway obstruction of the Korean population.

METHODS: In this study, we analyzed data provided by the forth and fifth Korean National Health and Nutrition Survey (KNHANES IV-V), a cross-sectional survey of the Korean population regarding health related behavior, health condition, and nutritional state of Koreans. The pre-bronchodilator data from subjects who performed spirometry adequately aged above 40 years were analyzed. We determined the corresponding FEV1/FEV6 and FEV6 values to the gold standard cutoff values of FEV1/FVC and FVC for the diagnosis of airflow obstruction by generating a receiver-operator characteristic (ROC) curve to determine the greatest sum of sensitivity and specificity.

RESULTS: Total 9,281 spirometry data were included in this study. Among them 4,024 were male and 5,257 were female. 1,271 were confirmed as having chronic obstructive lung disease (COPD) according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) Guidelines. The data from this study indicate that FEV1/FEV6 <75% can be used as a valid alternative for the FEV1/FVC <70% cut-off points for the detection of airway obstruction. The statistical analysis demonstrated very good agreement between the two criteria. For the diagnosis of airflow limitation, new criteria of FEV1/FEV6 sensitivity was 95.1% and specificity was 94.6%; the positive predictive value (PPV) and negative predictive value (NPV) were 73.8% and 99.2%, respectively. Similar results were obtained for male, female and age subjects.

CONCLUSIONS: This study demonstrates that forced expiratory volume in one second/forced expiratory volume in six seconds <75% can be used as valid alternatives to forced expiratory volume in one second/forced vital capacity <70% as fixed cut-off point for the detection of an obstructive spirometric pattern in Korean adults above 40 years old.

CLINICAL IMPLICATIONS: This result may add a new information to develop a new guideline of COPD of the Korea.

DISCLOSURE: The following authors have nothing to disclose: HeeJin Park, JuHan Song, YoungSam Kim

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