Chest
Original ResearchFEV1/FVC Ratio of 70% Misclassifies Patients With Obstruction at the Extremes of Age
Section snippets
Materials and Methods
Consecutive spirometry tests from three hospitals at two academic medical centers between December 1, 2003, and February 29, 2004, were reviewed. Results were taken from the University Hospital at The Ohio State University, and from Indiana University Hospital and Wishard Memorial Hospital, both of which were a part of the Indiana University Medical Center. All PFTs were performed and reported with the goal of meeting ATS standards for acceptability and reproducibility.11 Tests were reviewed,
Results
A total of 1,503 PFT results were collected and analyzed from the 3-month period. A total of 1,003 were from The Ohio State University Medical Center and 500 from the Indiana University Medical Center (Wishard Memorial Hospital, 248 PFT results; Indiana University Medical Center, 252 PFT results). Table 1shows the distribution of subjects.
The percentage of PFT results that were classified as obstruction varied markedly based on which method of diagnosis was used (ranging from 55% of patients
Discussion
The ATS recommends12 using a statistically based method for the determination of LLN, and the newest ATS guidelines2 recommend the use of the Hankinson data set as the data set to be used in the US population. The National Lung Health Education Program recommends that primary care practitioners use the data set of the Third National Health and Nutrition Examination Study (the Hankinson data set) and define the LLN for the purposes of diagnosis of obstruction in screening office spirometry.9
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