Screening Tool for Restrictive and Obstructive Ventilatory Abnormalities in a Population-Based Survey

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Abstract

BACKGROUND: A 6 s spirometry with an inexpensive pocket spirometer efficiently selects individuals for a diagnostic-quality spirometry for airflow limitation, but could also be useful to identify individuals with a restrictive pattern. OBJECTIVES: We evaluated an inexpensive simplified spirometer (chronic obstructive pulmonary disease [COPD]-6) as a screening tool to identify spirometric abnormalities. METHODS: A population-based survey in Mexico City, with 742 participants performing pre- and post-BD spirometry and a three-maneuver 6 s spirometry (pre-BD) with a COPD-6. We evaluated forced expiratory volume in 1 s (FEV1), FEV6, and FEV1/FEV6 from the COPD-6, crude and expressed as the percentage of predicted (%P), to discriminate post-bronchodilator airflow obstruction (FEV1/forced vital capacity [FVC] < 5th percentile) or restriction (FVC or FEV1 <5th percentile with normal FEV1/FVC) through receiver operating characteristics and their area under the curve (AUC). RESULTS: FEV1%P was the best predictor to identify pre- and post-BD ventilatory abnormalities (best cutoff point 87%P, AUC 92% for restrictive pattern, 89% for obstructive pattern, and 91% for any spirometric abnormality). Deriving to clinical spirometry only those with < 87%P (26% of the sample) missed only 12% of spirometric abnormalities most of the latter mild. CONCLUSIONS: An FEV1 < 87%P from a pre-BD 6 s spirometry correctly identified individuals with spirometric ventilatory defects, either obstructive or restrictive.

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APA

Fernandez-Plata, R., Thirion-Romero, I., Martinez-Briseño, D., Franco-Marina, F., & Perez-Padilla, R. (2020). Screening Tool for Restrictive and Obstructive Ventilatory Abnormalities in a Population-Based Survey. Revista de Investigacion Clinica; Organo Del Hospital de Enfermedades de La Nutricion, 72(6), 386–393. https://doi.org/10.24875/RIC.20000235

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