Affiliation:
1. National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University Guangzhou Guangdong China
Abstract
AbstractBackground and ObjectiveThe use of small airway parameters generated by spirometry, namely forced expiratory flow between 25% and 75% of forced vital capacity (FVC) (FEF25%–75%) and forced expiratory flow at 50% and 75% of FVC (FEF50% and FEF75%, respectively), is widely discussed. We evaluated the importance of these spirometric parameters in a large Chinese population.MethodsWe conducted a cross‐sectional observational study in which spirometry and bronchodilator responsiveness (BDR) data were collected in a healthcare centre from May 2021 to August 2022 and in a tertiary hospital from January 2017 to March 2022. Discordance was assessed between the classification of test results by the large airway parameters of forced expiratory volume in 1 second (FEV1) and FEV1/FVC ratio and by the small airway parameters of FEF25%–75%, FEF75% and FEF50%. The predictive power of Z‐scores of spirometric parameters for airflow limitation and BDR was assessed using receiver operating characteristic curves.ResultsOur study included 26,658 people. Among people with a normal FVC (n = 14,688), 3.7%, 4.5% and 3.6% of cases exhibited normal FEV1/FVC ratio but impaired FEF25%–75%, FEF75% and FEF50%, respectively, while 6.8%–7.0% of people exhibited normal FEV1 but impaired FEF25%–75%, FEF75% and FEF50%. Using the Z‐scores of combining both large and small airway parameters in spirometry showed the best area under the curve for predicting airflow limitation (0.90; 95% CI 0.87–0.94) and predicting BDR (0.72; 95% CI 0.71–0.73).ConclusionIt is important to consider both large and small airway parameters in spirometry to avoid missing a diagnosis of airflow obstruction.image
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2 articles.
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