Assessment of the Portable COPD-6 Device for Detecting Obstructive Airway Diseases

Represas, Cristina Represas; Rial, Maribel Botana; Fernández, Virginia Leiro; Silva, Ana Isabel González; del Campo Pérez, Víctor; Fernández-Villar, Alberto

doi:10.1016/S1579-2129(10)70101-4

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Vol. 46. Issue 8.

Pages 426-432 (January 2010)

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Pages 426-432 (January 2010)

Original Article

DOI: 10.1016/S1579-2129(10)70101-4

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Assessment of the Portable COPD-6 Device for Detecting Obstructive Airway Diseases

Validación del dispositivo portátil COPD-6 para la detección de patologías obstructivas de la vía aérea

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Cristina Represas Represasa,b,d, Maribel Botana Riala,b,d, Virginia Leiro Fernándeza,b,d, Ana Isabel González Silvaa,b,d, Víctor del Campo Pérezc,d, Alberto Fernández-Villara,b,d,

Corresponding author

alberto.fernandez.villar@sergas.es

Corresponding author.

a Grupo de Investigación en Enfermedades Respiratorias e Infecciosas, Complejo Hospitalario Universitario de Vigo, Vigo, Spain

b Servicio de Neumología, Complejo Hospitalario Universitario de Vigo, Vigo, Spain

c Servicio de Medicina Preventiva, Complejo Hospitalario Universitario de Vigo, Vigo, Spain

d Instituto de Investigación Biomédica de Vigo (IBIV), Vigo, Spain

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Abstract

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Abstract

Objectives

To evaluate the agreement and the association with FEV1, FEV6 and FEV1/FEV6 measured with the Vitalograph-COPD-6 portable device and the FEV1, FVC and FEV1/FVC by conventional spirometry, and to analyse the validity of this device to detect obstruction.

Methodology

A cross-sectional, descriptive, prospective study, that included 180 subjects. A conventional spirometry and a spirometry with the Vitalograph-COPD-6 were sequentially performed on them. The agreement was analysed [kappa index and interclass correlation coefficient (ICC)], as well as the association [Pearson correlation coefficient (r)], area under the ROC curve (AUC) of the FEV1/FEV6 in detecting obstruction, and the sensitivity, specificity, predictive values (PPV and NPV), and probability ratios (PR+ and PR–) of the different FEV1/FEV6 cut-off points in the detection of obstruction.

Results

The prevalence of obstruction was 47 %. The kappa index was 0.59 when an FEV1/FEV6 < cut-off point of < 0.7 was used. The ICC and the r between the FEV1 measured by the two instruments, FEV6 and FEV1/FEV6 measured by the Vitalograph-COPD-6 and the FVC and FEV1/FVC determined by the spirometer were all greater than 0.92. The ROC AUC was 0.97. To detect obstruction, if the cut-off point of FEV1/FEV6 (for COPD-6) was < 0.70, the sensitivity, specificity, PPV, NPV, CR+ and CR– were, 58 %, 100 %, 100 %, 73 %, ∞ and 0.42, respectively. For a cut-off point of < 0.8, they were 96 %, 76 %, 78 %, 96 %, 3.8 and 0.05, respectively.

Conclusions

The portable Vitalograph-COPD-6 device is precise for the detection of airway obstruction. The best sensitivity/specificity of FEV1/FEV6 was obtained with cut-off points greater than 0.7.

Keywords:

FEV6

Spirometry

Screening

Chronic obstructive pulmonary disease

Resumen

Objetivos

Evaluar la concordancia y la relación del FEV1, FEV6 y FEV1/FEV6 medidos con el dispositivo portátil Vitalograph-COPD-6 y del FEV1, FVC y FEV1/FVC mediante espirometría convencional y analizar la validez de este dispositivo para detectar obstrucción.

Metodología

Estudio prospectivo, descriptivo, transversal. Se incluyeron 180 sujetos a los que se les realizó secuencialmente una espirometría convencional y una con el Vitalograph-COPD-6. Se analizó la concordancia (índice kappa y coeficiente de correlación intraclase [CCI]), relación (coeficiente de correlación de Pear son [r]), área bajo la curva (ABC) ROC del FEV1/FEV6 en la detección de obstrucción y se calcularon la sensibilidad, especificidad, valores predictivos (VPP y VPN) y cocientes de probabilidad (CP+ y CP–) de distintos puntos de corte del FEV1/FEV6 en la detección de obstrucción.

Resultados

La prevalencia de obstrucción fue del 47 %. Utilizando un punto de corte del FEV1/FEV6 < 0,7 el índice kappa fue de 0,59. El CCI y el r entre el FEV1 medido por los 2 aparatos, FEV6 y FEV1/FEV6 medido por el Vitalograph-COPD-6 y la FVC y FEV1/FVC determinados por el espirómetro fueron todos superiores a 0,92. El ABC ROC fue de 0,97. Para detectar obstrucción, si el punto de corte de FEV1/FEV6 (por COPD-6) es < 0,70, la sensibilidad, especificidad, VPP, VPN, CP + y CP– fueron 58 %, 100 %, 100 %, 73 %, ∞ y 0,42, respectivamente. Para un punto de corte < 0,80 fueron 96 %, 76 %, 78 %, 96 %, 3,8 y 0,05, respectivamente.

Conclusiones

El medidor portátil Vitalograph-COPD-6 es preciso para la detección de obstrucción de la vía aérea. La mejor relación sensibilidad/especificidad del cociente FEV1/FEV6 se obtuvo con puntos de corte superiores a 0,7.

Palabras clave:

FEV6

Espirometría

Cribado

Enfermedad pulmonar obstructiva crónica

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