Jove
Visualize
Contact Us
JoVE
x logofacebook logolinkedin logoyoutube logo
ABOUT JoVE
OverviewLeadershipBlogJoVE Help Center
AUTHORS
Publishing ProcessEditorial BoardScope & PoliciesPeer ReviewFAQSubmit
LIBRARIANS
TestimonialsSubscriptionsAccessResourcesLibrary Advisory BoardFAQ
RESEARCH
JoVE JournalMethods CollectionsJoVE Encyclopedia of ExperimentsArchive
EDUCATION
JoVE CoreJoVE BusinessJoVE Science EducationJoVE Lab ManualFaculty Resource CenterFaculty Site
Terms & Conditions of Use
Privacy Policy
Policies

Related Experiment Videos

Case definitions for chronic obstructive pulmonary disease.

Eva Hnizdo1, Henry W Glindmeyer, Edward L Petsonk

  • 1Division of Respiratory Disease Studies, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, West Virginia 26505, USA. ehnizdo@cdc.gov

COPD
|December 21, 2006
PubMed
Summary
This summary is machine-generated.

Related Concept Videos

You might also read

Related Articles

Articles linked to this work by shared authors, journal, and citation graph.

Sort by
Same author

A cohort study of forced vital capacity, airway obstruction, and survival in the multinational Burden of Obstructive Lung Disease study.

International journal of epidemiology·2026
Same author

The global burden of COPD: epidemiology and effect of prevention strategies.

The Lancet. Respiratory medicine·2025
Same author

Geographical variation in lung function: Results from the multicentric cross-sectional BOLD study.

Pulmonology·2024
Same author

Cohort Profile: Burden of Obstructive Lung Disease (BOLD) study.

International journal of epidemiology·2023
Same author

Historical shift in pathological type of progressive massive fibrosis among coal miners in the USA.

Occupational and environmental medicine·2023
Same author

The association of spirometric small airways obstruction with respiratory symptoms, cardiometabolic diseases, and quality of life: results from the Burden of Obstructive Lung Disease (BOLD) study.

Respiratory research·2023
Same journal

Global, Regional, and National Burden of COPD Attributable to Secondhand Smoke from 1990 to 2021: Findings from the Global Burden of Disease Study 2021.

COPD·2026
Same journal

Upregulation of LncRNA MIR31HG in COPD Correlates with Disease Severity and Facilitates Inflammation via miR-342-3p.

COPD·2026
Same journal

Methodological Considerations in the Development of the AECOPD "Infection Score".

COPD·2026
Same journal

Barriers and Facilitators to Treatment Plan Adoption and Self-Management in People with Chronic Obstructive Pulmonary Disease (COPD): A Systematic Search and Narrative Synthesis.

COPD·2026
Same journal

Airway Mucus Occlusions in Ex-Smokers with and Without COPD.

COPD·2026
Same journal

Symptom Improvement with BDP/FF/G Fixed Triple Inhalation Powder in Moderate to Severe COPD Patients Uncontrolled with Dual Therapies: A Non-Interventional, Open-Label, Single-Arm, Prospective Study (RESPONSE Slovenia).

COPD·2026
See all related articles

The fixed ratio definition for chronic obstructive pulmonary disease (COPD) misclassifies airflow obstruction, underdiagnosing younger adults and overdiagnosing older adults. This highlights potential undiagnosed respiratory disease in younger symptomatic populations.

Area of Science:

  • Pulmonary Medicine
  • Epidemiology
  • Respiratory Diagnostics

Background:

  • Chronic Obstructive Pulmonary Disease (COPD) classification relies on spirometric criteria.
  • Current guidelines from the American Thoracic Society (ATS) and Global Initiative for Chronic Obstructive Lung Disease (GOLD) offer different definitions for airflow obstruction.
  • Accurate classification is crucial for diagnosis and management of COPD.

Purpose of the Study:

  • To compare the ATS lower limits of normal (LLN) criterion with the fixed ratio (FEV1/FVC < 0.70) criterion for classifying airflow obstruction.
  • To evaluate the impact of these definitions on COPD classification across different age groups.
  • To assess the prevalence of undiagnosed respiratory disease in symptomatic young adults.

Main Methods:

Related Experiment Videos

  • Utilized data from the U.S. population-based National Health and Nutrition Examination Survey III (NHANES III).
  • Compared individuals meeting airflow obstruction definitions based on FEV1/FVC < 0.70 versus the ATS LLN criterion.
  • Analyzed definitions in relation to physician-diagnosed obstructive airways diseases and respiratory symptoms.

    • Main Results:

    • The fixed ratio definition underestimates mild COPD in younger adults (20-49 years) by 29% and overestimates it in older adults (50-80 years) by 58% compared to FEV1/FVC < LLN.
    • For moderate COPD, the fixed ratio definition underestimates obstruction by 31% in younger adults and overestimates it by 37% in older adults.
    • An estimated 0.9 million (26%) symptomatic U.S. adults aged 20-49 with airflow obstruction (FEV1/FVC < LLN) may have undiagnosed respiratory disease.

    Conclusions:

    • The FEV1/FVC < 0.70 criterion leads to substantial under-diagnosis of airway obstruction in younger individuals.
    • Conversely, the fixed ratio criterion leads to substantial over-diagnosis of COPD in older individuals.
    • Rethinking spirometric criteria for COPD classification is necessary to improve diagnostic accuracy across age demographics.