Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/35345
Title: Can We Use Lung Function Thresholds and Respiratory Symptoms to Identify Pre-Chronic Obstructive Pulmonary Disease? A Prospective, Population-based Cohort Study.
Austin Authors: Tan, Daniel J;Lodge, Caroline J;Walters, E Haydn;Bui, Dinh S;Pham, Jonathan;Lowe, Adrian J;Bowatte, Gayan;Vicendese, Don;Erbas, Bircan;Johns, David P;James, Alan L;Frith, Peter;Hamilton, Garun S;Thomas, Paul S;Wood-Baker, Richard;Han, MeiLan K;Washko, George R;Abramson, Michael J;Perret, Jennifer L ;Dharmage, Shyamali C
Affiliation: Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia.;Monash Lung, Sleep, Allergy & Immunology, Monash Health, Melbourne, Victoria, Australia.
Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia.;Department of Basic Sciences, Faculty of Allied Health Sciences, University of Peradeniya, Peradeniya, Sri Lanka.
School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia.;Violet Vines Marshman Centre for Rural Health Research, La Trobe University, Bendigo, Victoria, Australia.
Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia.;School of Medicine, University of Tasmania, Hobart, Tasmania, Australia.
Department of Pulmonary Physiology and Sleep Medicine, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia.
College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia.
Monash Lung, Sleep, Allergy & Immunology, Monash Health, Melbourne, Victoria, Australia.;School of Clinical Sciences, and.
Prince of Wales Clinical School, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia.
School of Medicine, University of Tasmania, Hobart, Tasmania, Australia.
Division of Pulmonary and Critical Care Medicine, University of Michigan Health System, Ann Arbor, Michigan.
Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Boston, Massachusetts.
School of Public Health & Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
Respiratory and Sleep Medicine
Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia.
Institute for Breathing and Sleep
Issue Date: 15-Jun-2024
Publication information: American Journal of Respiratory and Critical Care Medicine 2024-06-15; 209(12)
Abstract: Rationale: The term "pre-chronic obstructive pulmonary disease" ("pre-COPD") refers to individuals at high risk of developing COPD who do not meet conventional spirometric criteria for airflow obstruction. New approaches to identifying these individuals are needed, particularly in younger populations. Objectives: To determine whether lung function thresholds and respiratory symptoms can be used to identify individuals at risk of developing COPD. Methods: The Tasmanian Longitudinal Health Study comprises a population-based cohort first studied in 1968 (at age 7 yr). Respiratory symptoms, pre- and post-bronchodilator (BD) spirometry, diffusing capacity, and static lung volumes were measured in a subgroup at age 45, and the incidence of COPD was assessed at age 53. For each lung function measure, z-scores were calculated using Global Lung Function Initiative references. The optimal threshold for best discrimination of COPD incidence was determined by the unweighted Youden index. Measurements and Main Results: Among 801 participants who did not have COPD at age 45, the optimal threshold for COPD incidence by age 53 was pre-BD FEV1/FVC z-score less than -1.264, corresponding to the lowest 10th percentile. Those below this threshold had a 36-fold increased risk of developing COPD over an 8-year follow-up period (risk ratio, 35.8; 95% confidence interval, 8.88 to 144), corresponding to a risk difference of 16.4% (95% confidence interval, 3.7 to 67.4). The sensitivity was 88%, and the specificity was 87%. Positive and negative likelihood ratios were 6.79 and 0.14, respectively. Respiratory symptoms, post-BD spirometry, diffusing capacity, and static lung volumes did not improve on the classification achieved by pre-BD FEV1/FVC alone. Conclusions: This is the first study, to our knowledge, to evaluate the discriminatory accuracy of spirometry, diffusing capacity, and static lung volume thresholds for COPD incidence in middle-aged adults. Our findings support the inclusion of pre-BD spirometry in the physiological definition of pre-COPD and indicate that pre-BD FEV1/FVC at the 10th percentile accurately identifies individuals at high risk of developing COPD in community-based settings.
URI: https://ahro.austin.org.au/austinjspui/handle/1/35345
DOI: 10.1164/rccm.202212-2330OC
ORCID: 0000-0003-3536-8756
0000-0002-4388-784X
0000-0001-7034-0615
Journal: American Journal of Respiratory and Critical Care Medicine
Start page: 1431
End page: 1440
PubMed URL: 38236192
ISSN: 1535-4970
Type: Journal Article
Subjects: COPD
diffusing capacity
lung volumes
pre-COPD
spirometry
Pulmonary Disease, Chronic Obstructive/physiopathology
Pulmonary Disease, Chronic Obstructive/diagnosis
Pulmonary Disease, Chronic Obstructive/epidemiology
Spirometry/methods
Tasmania/epidemiology
Respiratory Function Tests/methods
Appears in Collections:Journal articles

Show full item record

Page view(s)

52
checked on Jul 15, 2024

Google ScholarTM

Check


Items in AHRO are protected by copyright, with all rights reserved, unless otherwise indicated.