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Impact of body mass index on the predictive capacity of the COPD-6 device in the detection of airflow obstruction.

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BACKGROUND AND OBJECTIVE The portable COPD-6 device has been validated as a screening tool for airflow obstruction through the quantification of the FEV1/FEV6 ratio. To date, however, the impact of… Click to show full abstract

BACKGROUND AND OBJECTIVE The portable COPD-6 device has been validated as a screening tool for airflow obstruction through the quantification of the FEV1/FEV6 ratio. To date, however, the impact of body mass index (BMI) on its ability to predict airflow obstruction has not been evaluated. The aim of the study was to assess the predictive ability of COPD-6 to detect airflow obstruction based on the patient's BMI. MATERIAL AND METHOD A prospective and open cohort study in which 223 subjects who underwent conventional spirometry and COPD-6 were included. The area under the curve ROC (AUC) of FEV1/FEV6 was analysed in the detection of obstruction for all patients in addition to BMI (BMI<30kg/m2 and BMI≥30kg/m2). Sensitivity and specificity, negative and positive predictive value as well as likelihood ratio were calculated to determine the cut-off point of COPD-6 FEV1/FEV6 ratio with greater predictive capacity. RESULTS The COPD-6 allows ruling out airflow obstruction with AUC of the estimated ROC curve of 88% (95% CI 83-93). The cut-off point FEV1/FEV6 of 0.74-0.76 shows the best predictive capacity. However, this capacity is altered according to BMI with an increase in false positives in subjects with BMI≥30kg/ m2 when using the same cut-off point for the whole sample. CONCLUSION The choice of cut-off point FEV1/FEV6 for the detection of obstruction should be adjusted to the patient's BMI.

Keywords: obstruction; fev1 fev6; predictive capacity; airflow obstruction; copd

Journal Title: Medicina clinica
Year Published: 2017

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