FEV1/FEV6 Cutoff Points to Avoid False Negatives When Using Portable Devices, PICO-6 ® and COPD-6 ® , in COPD Detection in Primary Healthcare Services

• Published in: Journal of clinical medicine 2025-01, Vol.14 (2), p.576
• Main Authors: Hernandez-Mezquita, Miguel A, Santos-Ventura, Idania De Los, Hidalgo-Sierra, Vanesa, Pérez-Trullen, Alfonso, Garcia, Ruth García, Clavero-Sánchez, Tamara, Barrueco-Otero, Enrique
• Format: Article
• Language: English
• Subjects: Airway management; Chronic obstructive pulmonary disease; Clinical medicine; Diagnostic tests; Laboratories; Patients; Primary care; Spirometry
• ISSN: 2077-0383; 2077-0383
• DOI: 10.3390/jcm14020576

: Chronic obstructive pulmonary disease (COPD) is a frequent but underdiagnosed disease, primarily due to the lack of access to forced spirometry (FS) in primary care. Portable, easy-to-use expiratory flow meters like Piko-6 and COPD-6 that measure FEV , FEV , and FEV /FEV ratio provide an alternative. Given that Piko-6 and COPD-6 devices measure FEV but not FVC, the aim of the study is to determine the optimal cutoff value for the FEV /FEV ratio of each device to avoid false negatives when these devices are used for COPD screening in primary care (PC). : A total of 664 patients of 35 years of age or older with a cumulative tobacco consumption of 10 or more packs/year were recruited at two university hospitals. FS (gold standard) was performed and FEV , FVC, and FEV /FVC measurements were compared with FEV , FEV , and FEV /FEV measurements acquired using Piko-6 and COPD-6 devices. The devices were compared using statistical methods including Pearson correlation coefficients, the Youden index (YI), kappa coefficient, Bland-Altman plots, and ROC curves analysis. : Correlations between FEV /FEV using Piko-6 and COPD-6 and FEV /FVC with FS were 0.79 and 0.73, respectively. Piko-6 achieved the best YI in FEV /FEV (0.73), whereas for COPD-6 , it was 0.80. Concordance between Piko-6 and FS was 83.9% (kappa 0.67 ± 0.028) and for COPD-6 , it was 68.7% (kappa 0.42 ± 0.02). : This is the first study that compares two hand-held expiratory flow meters with FS. Piko-6 and COPD-6 devices are effective tools for COPD detection, as their measurements provide a good correlation with FS. In order to avoid false negative results, the FEV /FEV cutoff point needs to be increased to 0.73 and 0.80 with Piko-6 and COPD-6 , respectively.