Comparison between FEV₁/FEV₆ and FEV₁/FVC as screening of chronic obstructive pulmonary disease

Area of Science:

• Pulmonary Medicine
• Diagnostic Tools
• Respiratory Health

Background:

• Chronic Obstructive Pulmonary Disease (COPD) diagnosis relies on spirometry, typically using the FEV₁/FVC ratio.
• Screening tools for COPD require high sensitivity and specificity for early detection.
• Alternative spirometric measures are being explored to simplify COPD screening.

Purpose of the Study:

• To evaluate the efficacy of the FEV₁/FEV₆ ratio as a screening tool for COPD.
• To compare the diagnostic performance of FEV₁/FEV₆ against the established FEV₁/FVC ratio.

Main Methods:

• A cross-sectional study involving 117 subjects analyzed FEV₁/FEV₆ and FEV₁/FVC ratios.
• Spearman's correlation and Receiver-Operator Characteristic (ROC) curve analysis were employed.
• Sensitivity, specificity, and predictive values were calculated using FEV₁/FVC < 0.70 as the gold standard.

Main Results:

• A strong positive correlation (r = 0.636, P<0.001) was observed between FEV₁/FEV₆ and FEV₁/FVC.
• The area under the ROC curve was 0.862 (P<0.001), indicating good diagnostic ability.
• FEV₁/FEV₆ demonstrated a sensitivity of 93.02% and specificity of 67.74% at a cut-off of 0.75, with substantial agreement (κ = 0.634).

Conclusions:

• The FEV₁/FEV₆ ratio serves as a practical and effective alternative for COPD screening.
• Further multicenter studies are recommended to validate these findings and establish population-specific reference values.