Abstract
Aims
To determine the accuracy of the forced expiratory volume ratio at one and six seconds (FEV1/FEV6) using a hand-held, expiratory flow meter (PiKo-6®, nSpire Health, Inc.) to screen for chronic obstructive pulmonary disease (COPD) in primary care settings.
Methods
Current and former smokers (> 50 years old) with no previous respiratory diagnosis (case finding [CF] = 204 subjects) or with an asthma diagnosis (differential diagnosis [DD] = 93 subjects) were evaluated using validated questionnaires, pre-bronchodilator (BD) FEV1/FEV6 and post-BD FEV1/forced vital capacity (FVC) spirometry.
Results
The PiKo-6® FEV1/FEV6 showed good sensitivity and specificity (areas under the Receiver Operating Characteristic curves [95% confidence intervals]: CF = 0.85 [0.79, 0.90]; DD = 0.88 [0.80, 0.96]) and exceeded the accuracy of the questionnaires. An FEV1/FEV6 cutoff < 0.75 provided optimal sensitivity (CF = 81%; DD = 86%) and specificity (CF = 71%; DD = 67%) for COPD screening.
Conclusions
The PiKo-6® allows simple and reliable screening for COPD which could optimise early referral for spirometry and early, targeted interventions for COPD.
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Competing interests
PF, AC and JB have received past or present funding support for research or education from one or more pharmaceutical or other health technology companies None of the three has any direct or family financial interests in either of the sponsor companies
GG and DM are employees of Boehringer Ingelheim Pty Limited, manufacturer of SPIRIVA (tiotropium) and AR is an employee of Pfizer Australia Pty Limited [alliance partner of Boehringer Ingelheim Pty Limited on SPIRIVA (tiotropium)]
At the time this study was conducted, RA was an employee of Covance Pty Limited, a contract research organization that has received funding from several pharmaceutical or other health technology companies. The study was conducted independently from commercial interests. No drug manufactured or marketed by the sponsors was tested or used in this study
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Frith, P., Crockett, A., Beilby, J. et al. Simplified COPD screening: validation of the PiKo-6® in primary care. Prim Care Respir J 20, 190–198 (2011). https://doi.org/10.4104/pcrj.2011.00040
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DOI: https://doi.org/10.4104/pcrj.2011.00040
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