Chest
Original Research: Pulmonary Function TestingPeak Expiratory Flow Is Not a Quality Indicator for Spirometry: Peak Expiratory Flow Variability and FEV1 Are Poorly Correlated in an Elderly Population
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Materials and Methods
Participants from the Health, Aging, and Body Composition Study were analyzed. All participants were 70 to 79 years old during recruitment, free of disability in activities of daily living, and free of functional limitations. The institutional review boards at both field centers approved the study, and informed consent was obtained. Subjects performed spirometry and were coached to perform maximal efforts. A National Institute for Occupational Safety and Health volume-based spirometer using a
Results
Of the 3,075 participants in the Health, Aging, and Body Composition Study, 2,863 subjects performed the spirometric evaluation; 352 subjects were excluded because they did not meet ATS acceptability and reproducibility criteria (12.3% of total). Forty-seven subjects were excluded based on a 50% ΔPEF (1.9% of total). Data from 2,464 subjects were analyzed. The mean age of participants was 73.6 ± 2.86 years (± SD). Gender distribution was 49% male and 51% female. Fifty-nine percent of the
Discussion
Our study demonstrates that in healthy older subjects within a single test session, there is a poor correlation between PEF variability and FEV1 variability. An average 29% ΔPEF has an associated average ΔFEV1 of 1%. FEV1 is a stable measurement even with large changes in PEF. This suggests that FEV1 and PEF measure different aspects of lung function. This is not unexpected because PEF occurs in the first 100 to 200 ms of an expiratory effort and is considered a measure of large airway
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2012, ChestCitation Excerpt :It is also important to note that 19% of our subjects (173 of 902) did not meet the quality standards for spirometric maneuvers despite highly trained personnel. This limitation has been noted by others,36–41 and has been suggested as a limitation to the widespread use of spirometry as a screening tool. On the other hand, the more efficient application of spirometry in the clinical setting via a staged approach, including peak flow monitoring, as we used, could improve COPD screening efforts.
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This study was supported by contracts N01-AG-6–2101, N01-AG-6–2103, and N01-AG-6–2106, and was also supported in part by the Intramural Research program of the National Institutes of Health, National Institute on Aging.
The authors have no conflicts of interest to disclose.
Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/misc/reprints.shtml).