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Updated: Sep 14, 2025
Home-Based Prescribed Pulmonary Exercise in Patients with Stable Chronic Obstructive Pulmonary Disease
Published on: August 24, 2019
Navigating data availability challenges in healthcare: assessing the added value of pulmonary function testing to the
Khalid A Ishani1, Anders Westanmo2, Amy Gravely3
1University of Minnesota Medical School, Minneapolis, Minnesota, USA.
Objectives:
Pulmonary function testing (PFT) data, such as forced expiratory volume (FEV1) has become increasingly siloed from the electronic health record (EHR). We hypothesised that FEV1 %pred is independently associated with mortality risk, even after adjusting for the Care Assessment Needs (CAN) score, a validated method developed by the Veterans Health Administration (VA) to predict mortality. Additionally, we hypothesised that the integration of PFT data into the EHR has declined in recent years.
Methods:
We conducted a retrospective cohort study using national VA data on PFTs from 2013 to 2018. Using logistic regression adjusted for CAN scores, we assessed the associations between FEV1 percent predicted (%pred) and all-cause mortality at 1 year and 5 years.
Results:
While the number of PFTs performed has generally increased since 2000, the integration of PFT data into the EHR has declined since 2006. The CAN-adjusted odds of 1-year mortality were 2.94 (95% CI: 2.66 to 3.24) for those with FEV1 %pred <35%, compared with those with FEV1 %pred ≥70%, while 5-year mortality odds were 3.83 (95% CI: 3.58 to 4.09).
Discussion:
Our study shows that FEV1 %pred is statistically significantly associated with increased risk of mortality, above and beyond the CAN score. However, the declining integration of PFT data into the VA EHR highlights a concerning trend of isolating critical test results from clinical care.
Conclusion:
Among people with FEV1 recorded in the EHR, FEV1 %pred is statistically significantly associated with increased risk of both 1-year and 5-year mortality, above and beyond the CAN score.
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