Pulmonary Physiology |

Validation of Forced Expiratory Volume at 6 Seconds of Exhalation (FEV6) in the Detection of Small Airway Disease FREE TO VIEW

Edgardo Tiglao, MD; Teresita DeGuia, MD; Maria Encarnita Limpin, MD; Aileen Guzman-Banzon, MD
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Philippine Heart Center, Quezon City, Philippines

Chest. 2015;148(4_MeetingAbstracts):894A. doi:10.1378/chest.2277470
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SESSION TITLE: Pulmonary Physiology Posters

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 28, 2015 at 01:30 PM - 02:30 PM

PURPOSE: Small airway disease continuous to be an important component of patients with chronic obstructive pulmonary disease (COPD). Spirometric measurements for assessing small airway pathology are simple to obtain, low-cost, readily available and show acceptable repeatability. In this study, we wanted to determine the accuracy of forced expiratory volume in six seconds of exhalation (FEV6) in detecting small airway disease using forced expiratory flow 25%-75% of FVC (FEF25% -75%) as a reference standard among Filipino patients

METHODS: This is a cross-sectional study done at Philippine Heart Center- Pulmonary Laboratory. All adult patients who underwent spirometric studies from October 2013 to September 2014 were included. Baseline demographic data, smoking history and spirometric results were evaluated. The highest post-bronchodilator FEF 25-75% and FEV6 from test of acceptable quality were used for analysis. We used FEF25% -75% as the reference standard for detecting small airway disease. Each subject was categorized as having “ small airway disease” if the postbronchodilator value of FEF 25% -75% is <65% of the predicted as the lower limit of normality. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of FEV6 in detecting small airway disease as defined by FEF 25-75% were calculated.

RESULTS: Of the 386 spirometric test analyzed, 245 were males and 141 were females. 61% of the subjects had smoking history and 33% had significant airflow obstruction. FEV6 has a 35.40 % sensitivity and has 35.63% specificity in detecting small airway disease. With a positive and negative predictive values of 43.52% and 28.08% respectively. Subgroup analysis among subjects with airflow obstruction showed 62.20% diagnostic accuracy and 73.04 % diagnostic accuracy among those with smoking history.

CONCLUSIONS: The study demonstrated that FEV6 has a limited value in detecting small airway disease among adult Filipino patients. We still recommend the use of forced expiratory flow 25%-75% of FVC (FEF 25% -75%) in screening of patients with possible small airway disease. Nevertheless, the study proved that FEV6 can qualify small airway disease among patients with significant airflow obstruction and smoking history.

CLINICAL IMPLICATIONS: Forced expiratory volume at 6 seconds (FEV6) has a limited value in detecting small airway disease among adult patients. However, its value can be represented by patients with significant airway obstruction and smoking history.

DISCLOSURE: The following authors have nothing to disclose: Edgardo Tiglao, Teresita DeGuia, Maria Encarnita Limpin, Aileen Guzman-Banzon

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