Spirometry Threshold Establishes Diagnosis of Clinically Significant COPD

MedicalResearch.com Interview with:

Elizabeth C. Oelsner, MD, MPH Irving Assistant Professor of Medicine Division of General Medicine New York Presbyterian Columbia University

Dr. Oelsner

Elizabeth C. Oelsner, MD, MPH
Irving Assistant Professor of Medicine
Division of General Medicine
New York Presbyterian
Columbia University

MedicalResearch.com: What is the background for this study?

Response: Uncertainty regarding how to diagnose chronic obstructive pulmonary disease (COPD) has posed significant problems for early detection and treatment of this common disease. Simplifying and standardizing the diagnosis of COPD has the potential to improve diagnosis, clinical care, and clinical research for this common and under-diagnosed chronic lung disease.

We therefore aimed to provide robust evidence for the best threshold to diagnose COPD by comparing how well various thresholds predict hospitalizations and deaths from COPD.

MedicalResearch.com: What are the main findings?

Response: We used data from the NHLBI Pooled Cohorts Study, which combined numerous existing multi-ethnic cohort studies to support large-scale studies of COPD. We found that the fixed threshold of 0.70, which is recommended by current guidelines, proved as accurate, or more accurate, than other thresholds. 

MedicalResearch.com: What should readers take away from your report? 

Response: For clinicians, our study supports the continued use of spirometry – a non-invasive, cost-effective, reliable breathing test – for diagnosing airflow obstruction in COPD. It demonstrates the prognostic accuracy of the currently recommended, fixed threshold of 0.70 for clinically significant COPD. 

MedicalResearch.com: What recommendations do you have for future research as a result of this work? 

Response: In light of the clinical and public health burden of COPD, further research on how to improve prevention, early detection, and appropriate treatment is urgently needed. 

MedicalResearch.com: Is there anything else you would like to add?

Response: This study highlights the potential to use NIH-funded cohort studies to explore fundamental questions regarding COPD and other respiratory conditions. I have no disclosures beyond grant funding from NIH/NHLBI.

Citation: 

Bhatt SP, Balte PP, Schwartz JE, et al. Discriminative Accuracy of FEV1:FVC Thresholds for COPD-Related Hospitalization and Mortality. JAMA. 2019;321(24):2438–2447. doi:10.1001/jama.2019.7233 

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