Stick with the Guideline-Recommended Threshold of 0.70 to Diagnose Airway Obstruction

The forced expiratory volume in 1 second to forced vital capacity ratio of 0.70 was more accurate than the lower limit of normal for predicting chronic obstructive pulmonary disease–related events.

Demonstration of airway obstruction (by spirometry) is required for diagnosing chronic obstructive pulmonary disease (COPD). Current Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines recommend use of a fixed threshold of forced expiratory volume in 1 second to forced vital capacity (FEV₁:FVC) of 0.70. However, some clinicians advocate use of the lower limit of normal (LLN) of the FEV₁:FVC ratio, as it incorporates demographics, including age, sex, height, and self-identified race, in determining “normal.”

Researchers studied more than 24,000 patients (mean age, 63) from four large U.S. cohorts to identify the appropriate FEV₁:FVC threshold for COPD diagnosis. When the LLN was used, COPD was diagnosed in 15% of patients…

Reviewing Author

Patricia Kritek, MD

Disclosures

Editorial BoardsATS Scholar

Patricia Kritek, MD

Disclosures

Editorial BoardsATS Scholar

Stick with the Guideline-Recommended Threshold of 0.70 to Diagnose Airway Obstruction

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Reviewing Author