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

Background: The prevalence of asthma and chronic obstructive pulmonary disease (COPD) is high (similar to 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%); COPDI: 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. Copyright (C) 2009 S. Karger AG, Basel