TY - JOUR
T1 - Concordance between FVC and FEV6 for identifying chronic airflow obstruction and spirometric restriction in the Burden of Obstructive Lung Disease (BOLD) study
AU - BOLD Collaborative Research Group
AU - Knox-Brown, Ben
AU - Potts, James
AU - Franssen, Frits M E
AU - Nielsen, Rune
AU - Denguezli, Meriam
AU - Rotevatn, Anders Ørskov
AU - Juvekar, Sanjay K
AU - Cherkaski, Hamid Hacene
AU - Studnicka, Michael
AU - Sylvester, Karl Peter
AU - Mortimer, Kevin
AU - Bateman, Eric D
AU - Janson, Christer
AU - Malinovschi, Andrei
AU - Seemungal, Terence
AU - Koul, Parvaiz
AU - Mannino, David
AU - Mahesh, Padukudru Anand
AU - Jogi, Rain
AU - Mejza, Filip
AU - Al Ghobain, Mohammed
AU - Paraguas, Stefanni Nonna M
AU - Welte, Tobias
AU - Wouters, Emiel
AU - Gislason, Thorarinn
AU - Harrabi, Imed
AU - Dias, Hermínia
AU - Obaseki, Daniel O
AU - Kocabas, Ali
AU - Barbara, Cristina
AU - Cardoso, Joao
AU - Agarwal, Dhiraj
AU - Nafees, Asaad Ahmed
AU - Rodrigues, Fatima
AU - Garcia-Larsen, Vanessa
AU - Erhabor, Gregory E
AU - Loh, Li-Cher
AU - Amaral, Andre F S
AU - Guðmundsson, Gunnar
N1 - Publisher Copyright:
© Author(s) (or their employer(s)) 2025.
PY - 2025/7/13
Y1 - 2025/7/13
N2 - INTRODUCTION: We investigated whether the forced expiratory volume in 6 s (FEV6) 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 FEV1/FEV6 less than the lower limit of normal (LLN) to correctly classify FEV1/FVC less than the LLN, and FEV6 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 FEV1/FVC, compared with 9% (2704) for FEV1/FEV6. 37% (10 637) had spirometric restriction for FVC, compared with 35% (9978) for FEV6. The FEV1/FEV6 had excellent accuracy in identifying FEV1/FVC less than the LLN (area under the curve (AUC): 0.90, 95% CI, 0.89 to 0.91, κ coefficient 0.82). The FEV6 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 FEV1/FEV6 (1%, 345) and FEV6 (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 FEV1/FEV6 and FEV6 were more likely to have chronic airflow obstruction and spirometric restriction at follow-up.CONCLUSIONS: There is strong agreement between the FVC and FEV6 in the identification of chronic airflow obstruction and spirometric restriction.
AB - INTRODUCTION: We investigated whether the forced expiratory volume in 6 s (FEV6) 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 FEV1/FEV6 less than the lower limit of normal (LLN) to correctly classify FEV1/FVC less than the LLN, and FEV6 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 FEV1/FVC, compared with 9% (2704) for FEV1/FEV6. 37% (10 637) had spirometric restriction for FVC, compared with 35% (9978) for FEV6. The FEV1/FEV6 had excellent accuracy in identifying FEV1/FVC less than the LLN (area under the curve (AUC): 0.90, 95% CI, 0.89 to 0.91, κ coefficient 0.82). The FEV6 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 FEV1/FEV6 (1%, 345) and FEV6 (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 FEV1/FEV6 and FEV6 were more likely to have chronic airflow obstruction and spirometric restriction at follow-up.CONCLUSIONS: There is strong agreement between the FVC and FEV6 in the identification of chronic airflow obstruction and spirometric restriction.
KW - Humans
KW - Female
KW - Male
KW - Spirometry/methods
KW - Middle Aged
KW - Vital Capacity/physiology
KW - Forced Expiratory Volume/physiology
KW - Pulmonary Disease, Chronic Obstructive/diagnosis
KW - Aged
KW - Quality of Life
KW - Adult
KW - ROC Curve
KW - Cohort Studies
KW - Respiratory Function Test
KW - Sensitivity and Specificity
KW - Clinical Epidemiology
KW - Respiratory Measurement
KW - Lung Physiology
UR - https://www.scopus.com/pages/publications/105010894234
M3 - Article
C2 - 40659415
SN - 2052-4439
VL - 12
JO - BMJ Open Respiratory Research
JF - BMJ Open Respiratory Research
IS - 1
M1 - e002355
ER -