G. Viegi et al., Prevalence of airways obstruction in a general population - European Respiratory Society vs American Thoracic Society definition, CHEST, 117(5), 2000, pp. 339S-345S
Citations number
29
Categorie Soggetti
Cardiovascular & Respiratory Systems","Cardiovascular & Hematology Research
Study objectives: To evaluate the distribution of airways obstruction in a
general population sample.
Methods: Cross-sectional epidemiologic survey of a general population sampl
e living in Po Delta area (North Italy). Data on respiratory symptoms, dise
ases, and risk factors were collected through standardized interviewer-admi
nistered questionnaires. Lung function tests were performed, with criteria
for defining airways obstruction based on the 1995 European Respiratory Soc
iety (ERS) statement (FEV1/vital capacity ratio < 88% predicted and < 89% p
redicted in men and women, respectively), "clinical" criteria (FEV1/FVC rat
io < 70%), and the 1986 American Thoracic Society (ATS) statement (FEV1/FVC
ratio < 75%).
Results: A total of 1,727 subjects aged > 25 years investigated from 1988 t
o 1991 were included. Prevalence rates of airways obstruction for subjects
25 to 45 years old and subjects greater than or equal to 46 years old were
as follows: ERS, 10.8% and 12.2%; clinical, 9.9% and 28.8%; and ATS, 27% an
d 57%, respectively. When considering only moderate/severe obstruction, the
rates were as follows: ERS, 0.4% and 3.6%; clinical, 0.3% and 4.4%; and AT
S, 0.5% and 5.2%, respectively. The trend was confirmed after stratifying f
or smoking habit and the presence/absence of respiratory symptoms/diseases.
The highest specificity and predictive value for any respiratory symptom/d
isease was shown by the ERS, and the lowest was shown by the ATS criterion,
while the reverse was true for sensitivity; overall accuracy was slightly
lower for the ATS criterion. Multiple logistic regression models indicated
a higher number of significant associations with known risk factors for air
ways obstruction according to clinical and ATS criteria than ERS criterion.
Conclusions: The prevalence of COPD in a general population depends very mu
ch on the criterion used for definition of airways obstruction. Further res
earch is needed to reach a standardized and epidemiologically consistent cr
iterion for airways obstruction.