Concordance between FVC and FEV 6 for identifying chronic airflow obstruction and spirometric restriction in the Burden of Obstructive Lung Disease (BOLD) study
Year: 2025
Type: article
Abstract: Introduction We investigated whether the forced expiratory volume in 6 s (FEV 6 ) can be used as a surrogate for the forced vital capacity (FVC). Methods The Burden of Obstructive Lung Disease is a multinational cohort study. At baseline, data were collected from adults, aged 40 years or older, from 41 sites across 34 countries. Participants from 18 sites were followed-up after a median of 8.3 years. Participants who completed the study core questionnaire and had acceptable post-bronchodilator spirometry were included. We performed receiver operating characteristic analyses to measure the ability of FEV 1 /FEV 6 less than the lower limit of normal (LLN) to correctly classify FEV 1 /FVC less than the LLN, and FEV 6 less than the LLN to correctly classify FVC less than the LLN. We used multilevel regression analyses to assess the association of discordant measurements with respiratory symptoms, quality of life and lung function decline. Results At baseline, 28 604 participants were included. 53% were female (15 060). 10% (2876) had chronic airflow obstruction for FEV 1 /FVC, compared with 9% (2704) for FEV 1 /FEV 6 . 37% (10 637) had spirometric restriction for FVC, compared with 35% (9978) for FEV 6 . The FEV 1 /FEV 6 had excellent accuracy in identifying FEV 1 /FVC less than the LLN (area under the curve (AUC): 0.90, 95% CI, 0.89 to 0.91, κ coefficient 0.82). The FEV 6 also had excellent agreement in identifying FVC less than the LLN (AUC: 0.95, 95% CI, 0.94 to 0.95, κ coefficient 0.90). Discordant reductions in FEV 1 /FEV 6 (1%, 345) and FEV 6 (1%, 309) were associated with greater odds of having respiratory symptoms and a lower physical quality of life. 3870 participants were followed up. Those with discordant reductions in FEV 1 /FEV 6 and FEV 6 were more likely to have chronic airflow obstruction and spirometric restriction at follow-up. Conclusions There is strong agreement between the FVC and FEV 6 in the identification of chronic airflow obstruction and spirometric restriction.
Source: BMJ Open Respiratory Research
Authors: Ben Knox-Brown, James Potts, Frits M E Franssen, Rune Nielsen, Meriam Denguezli, Anders Ørskov Rotevatn, Sanjay K Juvekar, Hamid Hacene Cherkaski, Michael Studnicka, Karl Peter Sylvester, Kevin Mortimer, Eric D Bateman, Christer Janson, Andrei Malinovschi, Terence Seemungal, Parvaiz Koul, David Mannino, Padukudru Anand Mahesh, Rain Jogi, Filip Mejza, Mohammed Al Ghobain, Stefanni Nonna M Paraguas, Tobias Welte, Emiel Wouters, Thorarinn Gislason, Imed Harrabi, Hermínia Dias, Daniel O Obaseki, Ali Kocabas, Cristina Barbara, Joao Cardoso, Dhiraj Agarwal, Asaad Ahmed Nafees, Fatima Rodrigues, Vanessa Garcia-Larsen, Gregory E Erhabor, Li-Cher Loh, Andre F S Amaral
Institutions: Royal Papworth Hospital, Papworth Hospital NHS Foundation Trust, Imperial College London, Maastricht University Medical Centre, Haukeland University Hospital, University of Sousse, University of Bergen, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Badji Mokhtar-Annaba University, Paracelsus Medical University, University of Cambridge, Liverpool University Hospitals NHS Foundation Trust, University of Cape Town, Uppsala University, University of the West Indies, Sher-i-Kashmir Institute of Medical Sciences, University of Kentucky, COPD Foundation, JSS Medical College and Hospital, Tartu University Hospital, Jagiellonian University, King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, Medizinische Hochschule Hannover, Sigmund Freud Privatuniversität Wien, University of Iceland, National University Hospital of Iceland, Universidade Politécnica de Lisboa, University of British Columbia, Obafemi Awolowo University, Cukurova University, University of Lisbon, Centro Hospitalar Lisboa Norte, Aga Khan University, Johns Hopkins University, University College Dublin, RCSI & UCD Malaysia Campus, Royal College of Surgeons in Ireland, NIHR Imperial Biomedical Research Centre
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,085
OpenAlex ID: W4412378846