Comparison between FEV1/FEV6 and FEV1/FVC as screening of chronic obstructive pulmonary disease
- Author:
Ng Seow Ching
;
Mohd Faizul Bin Abu Samah
;
Khaled Mohamed Helmy Abd El-Aziz
;
Sia Koon Ket
- Publication Type:Original article
- Keywords:
FEV1/FEV6;
FEV1/FVC;
chronic obstructive pulmonary disease
- MeSH:
Pulmonary Disease, Chronic Obstructive
- From:
The Medical Journal of Malaysia
2017;72(5):286-290
- CountryMalaysia
- Language:English
-
Abstract:
Objective: To compare FEV1/FEV6 to the standard spirometry
(FEV1/FVC) as a screening tool for COPD.
Methods: This cross-sectional study was conducted at
Hospital Tuanku Fauziah, Perlis, Malaysia from August 2015
to April 2016. FEV1/FEV6 and FEV1/FVC results of 117
subjects were analysed. Demographic data and spirometric
variables were tabulated. A scatter plot graph with
Spearman’s correlation was constructed for the correlation
between FEV1/FEV6 and FEV1/FVC. The sensitivity,
specificity, positive and negative predictive values of
FEV1/FEV6 were determined with reference to the gold
standard of FEV1/FVC ratio <0.70. Receiver-operator
characteristic (ROC) curve analysis and Kappa statistics
were used to determine the FEV1/FEV6 ratio in predicting an
FEV1/FVC ratio <0.70.
Results: Spearman’s correlation with r = 0.636 (P<0.001) was
demonstrated. The area under the ROC curve was 0.862
(95% confidence interval [CI]: 0.779 - 0.944, P<0.001). The
FEV1/FEV6 cut-off with the greatest sum of sensitivity and
specificity was 0.75. FEV1/FEV6 sensitivity, specificity,
positive and negative predictive values were 93.02%,
67.74%, 88.89% and 77.78% respectively. There was
substantial agreement between the two diagnostic cut-offs
(κ = 0.634; 95% CI: 0.471 - 0.797, P<0.001)
Conclusions: The FEV1/FEV6 ratio can be considered to be a
good alternative to the FEV1/FVC ratio for screening of
COPD. Larger multicentre study and better education on
spirometric techniques can validate similar study outcome
and establish reference values appropriate to the population
being studied.
