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Updated: Jun 20, 2026

A Reversible, Non-invasive Method for Airway Resistance Measurements and Bronchoalveolar Lavage Fluid Sampling in Mice

A Reversible, Non-invasive Method for Airway Resistance Measurements and Bronchoalveolar Lavage Fluid Sampling in Mice

Published on: April 13, 2010

What defines airflow obstruction in asthma?

I Cerveri¹, A G Corsico, S Accordini

¹IRCCS San Matteo Hospital Foundation, University of Pavia, Italy.

The European Respiratory Journal

|September 2, 2009

Summary

Fixed thresholds for diagnosing airflow obstruction in asthma misclassify many young adults. Current Global Initiative for Asthma (GINA) guidelines need revision to improve accuracy in asthma diagnosis.

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Last Updated: Jun 20, 2026

A Reversible, Non-invasive Method for Airway Resistance Measurements and Bronchoalveolar Lavage Fluid Sampling in Mice

A Reversible, Non-invasive Method for Airway Resistance Measurements and Bronchoalveolar Lavage Fluid Sampling in Mice

Published on: April 13, 2010

Area of Science:

Pulmonology
Respiratory Medicine
Clinical Diagnostics

Background:

Asthma guidelines from GINA and NHLBI offer conflicting definitions for airflow obstruction.
GINA suggests a fixed forced expiratory volume in 1 second (FEV1)/forced vital capacity (FVC) ratio, while NHLBI and ATS/ERS favor the lower limit of normality (LLN).
Fixed cut-off points may lead to misclassification of airflow obstruction, particularly in diverse populations.

Purpose of the Study:

To evaluate the sensitivity and specificity of fixed FEV1/FVC ratios (0.70, 0.75, 0.80) compared to LLN for diagnosing airflow obstruction in adult asthma patients.
To identify potential misclassifications in asthma diagnosis due to fixed ratio cut-offs in young adults.
To inform recommendations for revising asthma diagnostic criteria.

Main Methods:

Analysis of data from 815 adult asthma patients (aged 20-44) within the European Community Respiratory Health Survey.
Comparison of fixed FEV1/FVC ratios (0.70, 0.75, 0.80) against the LLN for diagnosing airflow obstruction.
Calculation of sensitivity and specificity for each fixed ratio in males and females.

Main Results:

Fixed FEV1/FVC ratios demonstrated variable sensitivity and specificity across different thresholds and sexes.
The 0.70 ratio showed high specificity but lower sensitivity, potentially underestimating obstruction.
The 0.80 ratio showed high sensitivity but lower specificity, potentially overestimating obstruction, especially in females.

Conclusions:

Fixed FEV1/FVC cut-off points lead to significant misidentification of airflow obstruction in young adults.
Current GINA criteria for defining airflow obstruction require revision to enhance diagnostic accuracy.
Utilizing LLN or sex- and age-adjusted criteria may improve asthma diagnosis compared to fixed ratios.