Respiration

Clinical Investigations

Measuring FEV6 for Detecting Early Airway Obstruction in the Primary Care Setting

Quality and Utility of the New PiKo-6 Device

Kaufmann M. · Hartl S. · Geyer K. · Breyer M.K. · Burghuber O.C.

Author affiliations

Department of Respiratory and Critical Care Medicine and Ludwig Boltzmann Institute for COPD, Otto Wagner Hospital, Vienna, Austria

Related Articles for ""

Respiration 2009;78:161–167

Log in to MyKarger to check if you already have access to this content.


Buy

  • FullText & PDF
  • Unlimited re-access via MyKarger
  • Unrestricted printing, no saving restrictions for personal use
read more

CHF 38.00 *
EUR 35.00 *
USD 39.00 *

Select

KAB

Buy a Karger Article Bundle (KAB) and profit from a discount!


If you would like to redeem your KAB credit, please log in.


Save over 20% compared to the individual article price.

Learn more

Rent/Cloud

  • Rent for 48h to view
  • Buy Cloud Access for unlimited viewing via different devices
  • Synchronizing in the ReadCube Cloud
  • Printing and saving restrictions apply

Rental: USD 8.50
Cloud: USD 20.00

Select

Subscribe

  • Access to all articles of the subscribed year(s) guaranteed for 5 years
  • Unlimited re-access via Subscriber Login or MyKarger
  • Unrestricted printing, no saving restrictions for personal use
read more

Subcription rates


Select
* The final prices may differ from the prices shown due to specifics of VAT rules.

Article / Publication Details

First-Page Preview
Abstract of Clinical Investigations

Received: July 11, 2008
Accepted: November 12, 2008
Published online: January 28, 2009
Issue release date: August 2009

Number of Print Pages: 7
Number of Figures: 2
Number of Tables: 5

ISSN: 0025-7931 (Print)
eISSN: 1423-0356 (Online)

For additional information: https://www.karger.com/RES

Abstract

Background: The prevalence of asthma and chronic obstructive pulmonary disease (COPD) is high (∼7.4–18%) in the general population, but less than half are diagnosed. Several studies have shown FEV6 as a good surrogate marker for forced vital capacity (FVC) to detect airflow limitations. Objectives: The aim of this study was to evaluate if it is possible to simplify and improve the diagnosis of so far undiagnosed asthma or COPD in the primary care setting by measuring FEV6 with a new simple screening device (PiKo-6). Methods: 507 patients were recruited from three general practices from May to June 2005. Patients with any known pulmonary disease were excluded by questionnaire. FEV1, FEV6 and FEV1/FEV6 were determined using a PiKo-6 device. Patients with an FEV1/FEV6 <80% (PiKo positive) were invited to a standardized pulmonary function test to confirm or rule out airflow limitation. Results: 401 (79.1%) patients showed FEV1/FEV6 ≥80% (PiKo negative), and 106 (20.9%) patients were PiKo positive. Of the 106 PiKo-positive patients, 74 patients (14.7% of total) agreed to further studies and 18 patients (3.6%) of them suffered from COPD [COPD 0: 5 (1.0%); COPD I: 9 (1.8%); COPD II: 4 (0.8%), and none with COPD III or IV] and 14 patients (2.8%) suffered from bronchial hyperresponsiveness or asthma. In 42 patients (8.3%), the pulmonary function test was normal. Conclusions: Measurement of FEV6 using a new simple screening device (PiKo-6) may improve the detection rate of undiagnosed airflow limitation in the primary care setting. However, patients should be carefully selected.

© 2009 S. Karger AG, Basel




Related Articles:


References

  1. Chapman KR, Mannino DM, Soriano JB, Vermeire PA, Buist AS, Thun MJ, Conell C, Jemal A, Lee TA, Miravitlles M, Aldington S, Beasley R: Epidemiology and costs of chronic obstructive pulmonary disease. Eur Respir J 2006;27:188–207.
  2. Hoogendoorn M, Rutten-von Mölken MPMH, Hoogenveen RT, van Genugten MLL, Buist AS, Wouters EFM, Feenstra TL: A dynamic population model of disease progression in COPD. Eur Respir J 2005;26:223–233.
  3. The Global Strategy for Asthma Management and Prevention, Global Initiative for Asthma (GINA) 2006. http://www.ginasthma.org (accessed July 13, 2006).
  4. Petty TL: Scope of the COPD problem in North America: early studies of prevalence and NHANES III data: basis for early identification and intervention. Chest 2000;117(5 suppl 2):326–331.
    External Resources
  5. Stang P, Lydick E, Silberman Ch, Kempel A, Keating ET: Prevalence of COPD: using smoking rates to estimate disease frequency in the general population. Chest 2000;117:354–359.
  6. Buist AS, McBurnie MA, Vollmer WM, Gillespie S, Burney P, Mannino DM, Menezes AM, Sullivan SD, Lee TA, Weiss KB, Jensen RL, Marks GB, Gulsvik A, Nizankowska-Mogilnicka E; BOLD Collaborative Research Group: International variation in the prevalence of COPD (the BOLD Study): a population-based prevalence study. Lancet 2007;370:741–750.
  7. Buffels J, Degryse J, Heyrman J, Decramer M: Office spirometry significantly improves early detection of COPD in general practice: the DIDASCO Study. Chest 2004;125:1394–1399.
  8. Celli BR, Halbert RJ, Nordyke RJ, Schau B: Airway obstruction in never smokers: results from the Third National Health and Nutrition Examination Survey. Am J Med 2005;118:1364–1372.
  9. Nihlén U, Montnémery P, Lindholm LH, Löfdahl CG: Detection of chronic obstructive pulmonary disease (COPD) in primary health care: role of spirometry and respiratory symptoms. Scand J Prim Health Care 1999;17:232–237.
  10. Pena SV, Miravitlles M, Gabriel R Jiménez-Ruiz CA, Villasante C, Masa JF, Viejo JL, Ferández-Fau L: Geographic variations in prevalence und underdiagnosis of COPD: results of the IBERBOC multicentre epidemiological study. Chest 2000;118:981–989.
  11. Shin C, Lee S, Abbott RD, Kim JH, Lee SY, In KH, Kimm KC: Respiratory symptoms and undiagnosed airflow obstruction in middle-aged adults: the Korean Health and Genome Study. Chest 2004;126:1234–1240.
  12. Stratelis G, Jakobsson P, Molstad S, Zetterstrom O: Early detection of COPD in primary care: screening by invitation of smokers aged 40 to 55 years. Br J Gen Pract 2004;54:201–206.
  13. Demir T, Ikitimur HD, Koc N, Yildirim N: The role of FEV6 in the detection of airway obstruction. Respir Med 2005;99:103–106.
  14. Vandevoorde J, Verbanck S, Schuermans D, Kartounian J, Vincken W: FEV1/FEV6 and FEV6 as an alternative for FEV1/FVC and FVC in the spirometric detection of airway obstruction and restriction. Chest 2005;127:1560–1564.
  15. Van Schayck CP, Halbert RJ, Nordyke RJ, Isonaka S, Maroni J, Nonikov D: Comparison of existing symptom-based questionnaires for identifying COPD in the general practice setting. Respirology 2005;10:323–333.
  16. Price DB, Tinkelman DG, Halbert RJ, Nordyke RJ, Isonaka S, Nonikov D, Juniper EF, Freeman D, Hausen T, Levy ML, Ostrem A, van der Molen T, van Schayck CP: Symptom-based questionnaire for identifying COPD in smokers. Respiration 2006;73:285–295.
  17. Van Schayck CP, Loozen JMC, Wagena E, Akkermans P, Wesseling GJ: Detecting patients at a high risk of developing chronic obstructive pulmonary disease in general practice: cross-sectional case finding study. BMJ 2002;324:1370.
  18. Akpinar-Elci M, Fedan KB, Enright PL: FEV6 as a surrogate for FVC in detecting airways obstruction and restriction in the workplace. Eur Respir J 2006;27:374–377.
  19. Vandevoorde J, Verbanck S, Schuermans D, Kartounian J, Vincken W: Obstructive and restrictive spirometric patterns: fixed cut-offs for FEV1/FEV6 and FEV6. Eur Respir J 2006;27:378–383.
  20. Fonseca JA, Costa-Pereira A, Delgado L, Silva LN, Magalhaes M, Castel-Branco MG, Vaz M: Pulmonary function electronic monitoring devices: a randomized agreement study. Chest 2005;128:1258–1265.
  21. Meuric S, Leroy M, Raffestin B, Bidat E: Compliance with and acceptability of a new electronic peak flow meter, the PiKo-1. Rev Mal Respir 2005;22:935–941.
  22. Guimarães M, Oliveira A, Rego A, Taveira N: Chronic obstructive pulmonary disease – home monitoring of FEV1 and PEF (PiKo® 1) (in Portuguese). Rev Port Pneumol 2005;11 (6 suppl 1):23–24.
  23. Rodríguez-Pascual L, Cordero-Guevara J, Viejo-Banuelos JL: Agreement between pneumotachograph and PiKo-1 measurements of PEF and FEV1. Arch Broncopneumol 2006;42:144–147.
    External Resources
  24. Salgado S, Teixeira J, Silva C, Moreira N, Barros R, Rocha M, Calaca P, Raposo L, Pinto P, Santos O, Bárbara C: Accuracy of electronic monitoring device PiKo-1 (in Portuguese). Rev Port Pneumol 2006;12(6 suppl 1):62.
  25. Diaz J, De Castro Mesa C, Gontán G, Salamanca MJ, López de Castro F: Prevalence of chronic obstructive pulmonary disease and risk factors in smokers and ex-smokers. Arch Bronconeumol 2003;39:554–558.
  26. Lusuardi M, De Benedetto F, Paggiaro P, Sanguinetti CM, Brazzola G, Ferri P, Donner CF: A randomized controlled trial on office spirometry in asthma and COPD in standard general practice: data from spirometry in asthma and COPD: a comparative evaluation Italian study. Chest 2006;129:844–852.
  27. van den Boom G, van Schayck CP, van Mölken MP, Tirimanna PRS, den Otter JJ, van Grunsven PM, Buitendijk MJ, van Herwaarden CLA, van Weel C: Active detection of chronic obstructive pulmonary disease and asthma in the general population. Results and economic consequences of the DIMCA program. Am J Respir Crit Care Med 1998;158:1730–1738.
  28. Coultas D, Mapel D, Gagnon R, Lydick E: The health impact of undiagnosed airflow obstruction in a national sample of United States adults. Am J Respir Crit Care Med 2001;164:372–377.
  29. Sterk PJ, Fabbri LM, Quanjer PHH, Cockcroft DW, O’Byrne PM, Anderson SD, Juniper EF, Malo JL: Airway responsiveness: standardized challenge testing with pharmacological, physical and sensitizing stimuli in adults. Eur Respir J 1993;6(suppl 16):53–83.
  30. Global initiative for chronic obstructive lung disease (GOLD). Global strategy for the diagnosis, management and prevention of chronic obstructive pulmonary disease. NHLBI/WHO Workshop updated report 2005. http://www.goldcopd.com.
  31. Schirnhofer L, Lamprecht B, Vollmer WM, Allison MJ, Studnicka M, Jensen RL, Buist AS: COPD prevalence in Salzburg, Austria: results from the burden of Obstructive Lung Disease (BOLD) Study. Chest 2007;131:29–36.
  32. Cerveri I, Accordini S, Corsico A, Zoia MC, Corozzi L, Cazzoletti L, Beccaria M, Marinoni A, Viegi G, De Marco R: Chronic cough and phlegm in young adults. Eur Respir J 2003;22:413–417.
  33. Tinkelman DG, Price DB, Nordyke RJ, Halbert RJ, Isonaka S, Nonikove D, Juniper EF, Freeman D, Hausen T, Levy ML, Østremh A, van der Molen T, van Schayck CP: Symptom-based questionnaire for differentiating COPD and asthma. Respiration 2006;73:296–305.

Article / Publication Details

First-Page Preview
Abstract of Clinical Investigations

Received: July 11, 2008
Accepted: November 12, 2008
Published online: January 28, 2009
Issue release date: August 2009

Number of Print Pages: 7
Number of Figures: 2
Number of Tables: 5

ISSN: 0025-7931 (Print)
eISSN: 1423-0356 (Online)

For additional information: https://www.karger.com/RES


Copyright / Drug Dosage / Disclaimer

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
TOP