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. 2013 Feb;15(2):152-6.
doi: 10.5812/ircmj.8163. Epub 2013 Feb 5.

Fixed Cut-Off for FEV1/FEV6 and FEV6 in Detection of Obstructive and Restrictive Patterns

Rokhsareh Aghili  1 , Maryam Kia, Alipasha Meysamie, Seyed Mojtaba Aghili, Omalbanin Paknejad
Affiliations

Fixed Cut-Off for FEV1/FEV6 and FEV6 in Detection of Obstructive and Restrictive Patterns

Rokhsareh Aghili et al. Iran Red Crescent Med J. 2013 Feb.

Abstract

Background: Chronic obstructive pulmonary diseases (COPD) have been defined by the Global Initiative for Chronic Obstructive Lung Disease (GOLD) as irreversible conditions which are diagnosed by fixed cut-off points of FEV1/FVC.

Objective: The aim of this study was to determine the cut-off points for FEV1/FEV6 ratio and FEV6 as alternatives for FEV1/FVC and FVC in detection of airway obstruction and lung restriction, respectively.

Materials and methods: A total of 318 Spiro metric examinations of subjects referred to Shariati hospital were analyzed. A subject was considered to have obstruction if FEV1/FVC was lower than 70%. The restriction was defined as FVC < 80% in the absence of obstruction. The Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of FEV1/FEV6 and FEV6 were calculated.

Results: This study shows that the current cut-off points used to detect obstruction and restriction can be replaced by FEV1/FEV6 < 71% and FEV6 < 83%, respectively. FEV1/FEV6 had sensitivity of 95.5% and specificity of 99.4%; the PPV and NPVs were 99.3% and 96.3%. The prevalence of obstruction was 49.4%. For restrictive pattern, FEV6 had sensitivity of 93%, specificity of 79.5% with PPV of 18% and NPV of 99.5%. The prevalence of restriction was 6.3%.

Conclusions: The FEV1/FEV6 ratio can be used as a valid surrogate for FEV1/FVC in the diagnosis of airway obstruction, especially for screening purposes in high-risk populations for COPD. Moreover, FEV6 is an acceptable alternative for FVC in detection of restrictive pattern.

Keywords: Pulmonary Disease, Chronic Obstructive; Pulmonary Function Tests.

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Figures

Figure 1.
Figure 1.. The ROC curve obtained for FEV1/FEV6, using the GOLD standard of FEV1/FVC < 70% for detection of pulmonary obstructive disease
Figure 2.
Figure 2.. The ROC curve obtained for FEV6 using the GOLD standard of FVC < 80% for detection of pulmonary obstructive disease
See this image and copyright information in PMC

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