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dc.contributor.authorKato, Berneteng
dc.contributor.authorGulsvik, Amundeng
dc.contributor.authorVollmer, Williameng
dc.contributor.authorJanson, Christereng
dc.contributor.authorStudnika, Michaeleng
dc.contributor.authorBuist, Soniaeng
dc.contributor.authorBurney, Petereng
dc.date.accessioned2013-05-23T10:49:18Z
dc.date.available2013-05-23T10:49:18Z
dc.date.issued2012-11-16eng
dc.identifier.citationRespiratory Research 2012, 13:102eng
dc.identifier.issn1465-9921eng
dc.identifier.urihttp://hdl.handle.net/1956/6650
dc.description.abstractBackground: Chronic Obstructive Pulmonary Disease (COPD) is defined by post-bronchodilator spirometry. Data on “normal values” come predominantly from pre-bronchodilator spirometry. The effects of this on diagnosis are unknown. Methods: Lower limits of normal (LLN) were estimated from “normal” participants in the Burden of Obstructive Lung Disease (BOLD) programme. Values separately derived using pre- and post-bronchodilator spirometry were compared. Sensitivity and specificity of criteria derived from pre-bronchodilator spirometry and pre-bronchodilator spirometry adjusted by a constant were assessed in the remaining population. The “gold standard” was the LLN for the post-bronchodilator spirometry in the “normal population”. For FEV1/FVC, sensitivity and specificity of criteria were also assessed when a fixed value of < 70% was used rather than LLN. Results: Of 6,600 participants with full data, 1,354 were defined as “normal”. Mean differences between pre- and post- bronchodilator measurements were small and the Bland-Altman plots showed no association between difference and mean value. Compared with using the gold standard, however, tests using pre-bronchodilator spirometry had a sensitivity and specificity of detecting a low FEV1 of 78.4% and 100%, a low FVC of 99.8% and 99.1% and a low FEV1/FVC ratio of 65% and 100%. Adjusting this by a constant improved the sensitivity without substantially altering the specificity for FEV1 (99%, 99.8%), FVC (97.4%, 99.9%) and FEV1/FVC (98.7%, 99.5%). Conclusions: Using pre-bronchodilator spirometry to derive norms for lung function reduces sensitivity compared to a post-bronchodilator gold standard. Adjustment of these values by a constant can improve validity of the test.eng
dc.language.isoengeng
dc.publisherBioMed Centraleng
dc.rightsAttribution CC BYeng
dc.rights.urihttp://creativecommons.org/licenses/by/2.0/eng
dc.subjectNormal valueseng
dc.subjectEuropean populationeng
dc.subjectBOLD studyeng
dc.titleCan spirometric norms be set using pre- or post- bronchodilator test results in older people?eng
dc.typePeer reviewedeng
dc.typeJournal articleeng
dc.rights.holderCopyright 2012 Kato et al.; licensee BioMed Central Ltd.
dc.type.versionpublishedVersioneng
bora.peerreviewedPeer reviewedeng
bora.journalTitleRespiratory Researcheng
bibo.volume12eng
bibo.doihttp://dx.doi.org/10.1186/1465-9921-13-102eng
dc.identifier.cristinID1040656eng
dc.identifier.doi10.1186/1465-9921-13-102


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