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Defining obstructive ventilatory defect in 2015.

Zied Affes1, Salaheddine Rekik1, Helmi Ben Saad1,2,3

  • 1Department of Physiology and Functional Exploration, Farhat HACHED University Hospital of Sousse, Sousse, Tunisia.

The Libyan Journal of Medicine
|October 11, 2015
PubMed
Summary
This summary is machine-generated.

The definition of obstructive ventilatory defect (OVD) significantly impacts diagnosis rates. Using the physiological definition (FEV1/FVC < LLN) detects more OVD cases than the operational definition (FEV1/FVC < 0.70).

Keywords:
FEV1/FVCfixed thresholdguidelinelower limit of normalobstructive ventilatory defectspirometry

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Area of Science:

  • Pulmonology
  • Respiratory Medicine
  • Clinical Diagnostics

Background:

  • There is no established consensus on the precise definition of obstructive ventilatory defect (OVD).
  • Two common definitions exist: the physiological definition using the lower limit of normal (LLN) for FEV1/FVC, and the operational definition using a fixed ratio of 0.70.
  • The discrepancy in definitions may lead to variations in OVD diagnosis.

Purpose of the Study:

  • To compare the percentage of subjects diagnosed with OVD using both the physiological (FEV1/FVC < LLN) and operational (FEV1/FVC < 0.70) definitions.
  • To analyze the impact of these definitions across different age groups and smoking statuses.

Main Methods:

  • A retrospective study analyzed data from 4,730 individuals aged 17-85 years undergoing lung function tests.
  • Subjects were categorized based on OVD presence/absence according to both definitions.
  • Analysis included subgroup comparisons for younger (<45 years), older (≥45 years), smokers, and non-smokers.

Main Results:

  • The physiological definition identified significantly more OVD cases (13.46-43.22% more) across the total sample, younger, and older groups compared to the operational definition.
  • The operational definition overdiagnosed OVD in 0.44-2.33% of non-smokers and smokers, while underdiagnosing it in 4.46-29.72% of smokers and non-smokers.
  • Individuals classified as 'physio (+), operat (-)' were younger and had higher FEV1 and FVC than those classified as 'physio (-), operat (+)'.

Conclusions:

  • The frequency of diagnosing obstructive ventilatory defects is highly dependent on the specific criteria used.
  • The choice between physiological and operational definitions significantly influences OVD detection rates, particularly in different age and smoking subgroups.
  • Further research may be needed to establish a standardized definition for OVD.