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Underestimation of ...
Underestimation of airflow obstruction among young adults using FEV1/FVC<70% as a fixed cut-off : a longitudinal evaluation of clinical and functional outcomes
- Article/chapterEnglish2008
Publisher, publication year, extent ...
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2008-05-20
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BMJ,2008
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printrdacarrier
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LIBRIS-ID:oai:DiVA.org:uu-16794
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https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-16794URI
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https://doi.org/10.1136/thx.2008.095554DOI
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Language:English
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Summary in:English
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Subject category:ref swepub-contenttype
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Subject category:art swepub-publicationtype
Notes
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Background: Early detection of airflow obstruction is particularly important among young adults because they are more likely to benefit from intervention. Using the forced expiratory volume in 1 s (FEV1) to forced vital capacity (FVC) (FEV1/FVC) <70% fixed ratio, airflow obstruction may be underdiagnosed. The lower limit of normal (LLN), which is statistically defined by the lower fifth percentile of a reference population, is physiologically appropriate but it still needs a clinical validation.Methods: To evaluate the characteristics and longitudinal outcomes of subjects misidentified as normal by the fixed ratio with respect to the LLN, 6249 participants (aged 20-44 years) in the European Community Respiratory Health Survey were examined and divided into three groups (absence of airflow obstruction by the LLN and the fixed ratio; presence of airflow obstruction only by the LLN; presence of airflow obstruction by the two criteria) for 1991-1993. LLN equations were obtained from normal non-smoking participants. A set of clinical and functional outcomes was evaluated in 1999-2002.Results: The misidentified subjects were 318 (5.1%); only 45.6% of the subjects with airflow obstruction by the LLN were also identified by the fixed cut-off. At baseline, FEV1 (107%, 97%, 85%) progressively decreased and bronchial hyperresponsiveness (slope 7.84, 6.32, 5.57) progressively increased across the three groups. During follow-up, misidentified subjects had a significantly higher risk of developing chronic obstructive pulmonary disease and a significantly higher use of health resources (medicines, emergency department visits/hospital admissions) because of breathing problems than subjects without airflow obstruction (p<0.001).Conclusions: Our findings show the importance of using statistically derived spirometric criteria to identify airflow obstruction.
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Corsico, Angelo G
(author)
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Accordini, Simone
(author)
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Niniano, Rosanna
(author)
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Ansaldo, Elena
(author)
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Antó, Josep M
(author)
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Künzli, Nino
(author)
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Janson, ChristerUppsala universitet,Lungmedicin och allergologi(Swepub:uu)chrisjn
(author)
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Sunyer, Jordi
(author)
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Jarvis, Deborah
(author)
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Svanes, Cecilie
(author)
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Gislason, Thorarinn
(author)
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Heinrich, Joachim
(author)
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Schouten, Jan P
(author)
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Wjst, Matthias
(author)
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Burney, Peter
(author)
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de Marco, Roberto
(author)
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Uppsala universitetLungmedicin och allergologi
(creator_code:org_t)
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In:Thorax: BMJ63:12, s. 1040-10450040-63761468-3296
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Cerveri, Isa
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Corsico, Angelo ...
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Accordini, Simon ...
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Niniano, Rosanna
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Ansaldo, Elena
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Antó, Josep M
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Künzli, Nino
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Janson, Christer
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Sunyer, Jordi
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Jarvis, Deborah
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Svanes, Cecilie
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Gislason, Thorar ...
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Heinrich, Joachi ...
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Schouten, Jan P
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Wjst, Matthias
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Burney, Peter
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de Marco, Robert ...
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