Suggestions(1)
Exact(6)
Current COPD guidelines advocate a fixed < 0.70 FEV1/FVcutpointntoto define airflow obstruction.
We used an FEV1/FVC ratio (forced expiratory volume in one second/forced vital capacity) of <0.70 to define airflow obstruction.
33 The NPV was estimated at 94.4%95%CI86.4%to4% to 98.5%) when using the fixed ratio of FEV1/forced vital capacity (FVC) <0.7 to define airflow obstruction.
We conclude that the use of the fixed 0.70 cutpoint for the FEV1/FVC ratio to define airflow obstruction does not seem to be an appropriate choice for primary care.
It is important to realize that the ongoing debate about the most appropriate way to define airflow obstruction [ 21, 22] is especially relevant for primary care physicians, as they are often confronted with middle-aged and elderly subjects who present with respiratory symptoms and who may or may not have COPD, asthma or another (respiratory) condition.
Increasing the minimum necessary number of outpatient visits with a primary ICD-9 code for COPD to define airflow obstruction resulted in minimal impact on the AUC beyond that provided by the presence of one or more outpatient diagnostic codes (models 1-3).
Similar(54)
62 Spirometrically defined airflow obstruction but no diagnosed COPD does not necessarily indicate underdiagnosis.
In other words, we can attribute it as one of the possible causes of spirometry defined airflow limitation within the normal variation for healthy people.
Until now only few studies have looked at the course of clinical markers of COPD prognosis or outcome in relation to criteria for defining airflow obstruction.
For comparability with previous studies, we defined airflow obstruction in two ways: (i) forced expiratory volume in 1 s (FEV1) to forced vital capacity (FVC) ratio less than the lower limit of normal (LLN); or (ii) FEV1/FVC <0.70 [ 7].
Our current study results suggest that spirometry defined airflow limitation by GOLD criteria with more than 100% of predicted FEV1 and FVC may suggest pulmonary dysanapsis as the normal variation in asymptomatic healthy subjects.
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