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What defines airflow obstruction in asthma?
JournalArticle (Originalarbeit in einer wissenschaftlichen Zeitschrift)
 
ID 1196737
Author(s) Cerveri, I.; Corsico, A. G.; Accordini, S.; Cervio, G.; Ansaldo, E.; Grosso, A.; Niniano, R.; Tsana Tegomo E.,; Anto, J. M.; Künzli, N.; Janson, C.; Sunyer, J.; Svanes, C.; Heinrich, J.; Schouten, J. P.; Wjst, M.; Pozzi, E.; de Marco R.,
Author(s) at UniBasel Künzli, Nino
Year 2009
Title What defines airflow obstruction in asthma?
Journal The European respiratory journal
Volume 34
Number 3
Pages / Article-Number 568-573
Keywords Airflow obstruction, asthma, diagnosis
Abstract Asthma guidelines from the Global Initiative for Asthma (GINA) and from the National Heart, Lung, and Blood Institute provide conflicting definitions of airflow obstruction, suggesting a fixed forced expiratory volume in 1 s (FEV(1))/forced vital capacity (FVC) cut-off point and the lower limit of normality (LLN), respectively. The LLN was recommended by the recent American Thoracic Society/European Respiratory Society guidelines on lung function testing. The problem in using fixed cut-off points is that they are set regardless of age and sex in an attempt to simplify diagnosis at the expense of misclassification. The sensitivity and specificity of fixed FEV(1)/FVC ratios of 0.70, 0.75 and 0.80 versus the LLN were evaluated in 815 subjects (aged 20-44 yrs) with a diagnosis of asthma within the framework of the European Community Respiratory Health Survey. In males, the 0.70 ratio showed 76.5% sensitivity and 100.0% specificity, the 0.75 ratio 100.0% sensitivity and 92.4% specificity, and the 0.80 ratio 100.0% sensitivity but 58.1% specificity. In females, the 0.70 ratio showed 57.3% sensitivity and 100.0% specificity, the 0.75 ratio 91.5% sensitivity and 95.9% specificity, and the 0.80 ratio 100.0% sensitivity but 72.9% specificity. The fixed cut-off points cause a lot of misidentification of airflow obstruction in young adults, with overestimation with the 0.80 ratio and underestimation with the 0.70 ratio. In conclusion, the GINA guidelines should change their criteria for defining airflow obstruction.
Publisher Munksgaard
ISSN/ISBN 0903-1936
edoc-URL http://edoc.unibas.ch/dok/A6006900
Full Text on edoc No
Digital Object Identifier DOI 10.1183/09031936.00172908
PubMed ID http://www.ncbi.nlm.nih.gov/pubmed/19720808
ISI-Number WOS:000269702800006
Document type (ISI) Article
 
   

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