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Submitted: 21 July 2009
HERDIN Record #: PCHRD072109120756

FEV1/FEV6 versus FEV1/FVC in the spirometric detection of airway obstruction among asians.

Teresita de Guia,
Evelyn M. Pingul,
Fernando G. Ayuyao

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Study objective - To determine the relationship of FEV1/FEV6 with FEV1/FVC in the spirometric detection of severity of airway obstruction among Asians at Philippine Heart Center.

Design - Cross Sectional Study

Materials and Methods ÃÆ'Æ'Æ’ÃÆ'‚¢ÃÆ'Æ'¢ÃÆ'¢â‚¬Ã...¡ÃÆ'‚¬ÃÆ'Æ'¢ÃÆ'¢â€Ã...¡Ã‚¬ÃÆ'‚ Patients who underwent spirometric studies at Philippine Heart Center Pulmonary Laboratory from May 2005 to April 30, 2006 were evaluated. Baseline demographic data, smoking history and spirometric results were evaluated. The highest postbronchodilator FEV1 , FEV6 and FEV1/FEV6 percent from tests of acceptable quality were used for analysis. Each subject was categorized as having "airway obstruction" by comparing both FEV1/ FVC and FEV1/FEV6 with the respective lower limits of normal defined by Hankinson and coworkers. We used FEV1/ FVC as the "gold standard" for diagnosing airway obstruction. The severity of airway obstruction was graded into one of four categories; possible normal variant (FEV1>100 percent predicted), mild (FEV1 70-100 percent predicted), moderate (FEV1 50-70 percent predicted), and severe (FEV1 <50 percent predicted).The sensitivity, specificity, positive predictive value (PPV) and negative predictive values (NPV) of FEV1/FEV6 percent in predicting airway obstruction as defined by FEV1/FVC were calculated. The agreement between test result classification based on FVC and FEV6 was calculated using the Kappa test.

Results ÃÆ'Æ'Æ’ÃÆ'‚¢ÃÆ'Æ'¢ÃÆ'¢â‚¬Ã...¡ÃÆ'‚¬ÃÆ'Æ'¢ÃÆ'¢â€Ã...¡Ã‚¬ÃÆ'‚ Of 597 spirometric tests analyzed, 352 were males and 245 were females. 78 percent of males were smokers. FEV1/FEV6 has 97.6 percent sensitivity and has 83.6 percent specificity in detecting mild airway obstruction, with a positive and negative predictive values of 93.1 percent and 93.3 percent respectively. Indeed, with a kappa value of 0.837, a very good overall performance was obtained for FEV1/FEV6 percent in detecting mild airway obstruction. In addition , a kappa value of 0.694 was a substantial agreement for FEV1/FEV6 in detecting moderate airway obstruction.

Conclusion - FEV6 is an aqpeptable surrogate for FVC in detecting airway obstruction in Asian adults.

Publication Type
Journal
Publication Sub Type
Journal Article, Original
Title
Philippine Heart Center Journal
Frequency
Others
Publication Date
January-March 2007
Volume
13
Issue
1
Page(s)
23-27

Objectives

General Objective: To determine the relationship of FEV1/FEV6 with FEV1/FVC in the spirometric detection of severity of airway obstruction among Asians at Philippine Heart Center.

Specific Objectives:

1. To determine the sensitivity and specificity of FEV1/FEV6 in detecting severity of airway obstruction.

2. To determine the positive predictive value and negative predictive value of FEV1/FEV6 in spirometric diagnosis of airway obstruction.

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Philippine Council for Health Research and Development Library Abstract Print Format (Request Document)