ArticleBMC pulmonary medicine2009
Diagnostic accuracy of spirometry in primary care.
Article in BMC pulmonary medicine, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 54 papers, 2 of them syntheses that pooled it.
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Who cites it
54 citing papers in PubMed, 2 syntheses or guidelines pooled it, 128 citations in OpenAlex.
- Accuracy of portable spirometers in the diagnosis of chronic obstructive pulmonary disease A meta-analysis.NPJ primary care respiratory medicine · 2022Pooled it
- Physiological tests of small airways function in diagnosing asthma: a systematic review.BMJ open respiratory research · 2020Pooled it
- Effect of e-learning and repeated performance feedback on spirometry test quality in family practice: a cluster trial.Annals of family medicineTrial
- Article
- The importance of office spirometry in guiding the management of patients with chronic airway disorders in primary care.BMC primary care · 2026Article
- Serum Eosinophil Cationic Protein (ECP) as a Biomarker for Distinguishing Pediatric Allergic Airway Diseases.International journal of molecular sciences · 2026Article
- Clinical validation of perfusion imaging with pulmonary function test data using Voronoi-based discretization.Physics in medicine and biology · 2026Article
- Prognostic Value of Impaired Spirometry in Patients with Myocardial Infarction: A Longitudinal Study of Two European Cohorts.International journal of chronic obstructive pulmonary disease · 2026Observational
- Erdosteine, but Not N-Acetylcysteine, is Associated with Improved Homogeneity of Alveolar Ventilation in Patients with Mild-to-Moderate COPD Treated with LABA/LAMA.International journal of chronic obstructive pulmonary disease · 2026Article
- A baseline study of interpretable machine learning using GC-MS breath VOCs for classifying asthma, bronchiectasis, and COPD.Scientific reports · 2025Article
- A current assessment of family physicians' knowledge and attitudes toward asthma management in primary care in Turkey according to the GINA strategy report.NPJ primary care respiratory medicine · 2025Article
- Disease Classification of Pulmonary Xenon Ventilation MRI Using Artificial Intelligence.Academic radiology · 2025Article
- Assessing the diagnostic accuracy of machine learning algorithms for identification of asthma in United States adults based on NHANES dataset.Scientific reports · 2025Article
- What is the Best Way to Diagnose Possible Asthma Patients with Negative Bronchodilator Reversibility Tests?Journal of asthma and allergy · 2024Article
- Anticipating undiagnosed asthma in symptomatic adults with normal pre- and post-bronchodilator spirometry: a decision tool for bronchial challenge testing.BMC pulmonary medicine · 2023Article
- Chronic Obstructive Pulmonary Disease Overdiagnosis and Overtreatment: A Meta-Analysis.Journal of clinical medicine · 2023Review
- Machine diagnosis of chronic obstructive pulmonary disease using a novel fast-response capnometer.Respiratory research · 2023Article
- Application of deep learning for bronchial asthma diagnostics using respiratory sound recordings.PeerJ. Computer science · 2023Article
- Prevalence of Spirometry Testing among Patients with Asthma and COPD in German General Practices.Healthcare (Basel, Switzerland) · 2022Article
- Airway Obstruction in Primary Care Patients: Need for Implementing Spirometry Use.Diagnostics (Basel, Switzerland) · 2022Article
Corrections and comments
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Authors and funding
7 authors at 5 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTo evaluate the sensitivity, specificity and predictive values of spirometry for the diagnosis of chronic obstructive pulmonary disease (COPD) and asthma in patients suspected of suffering from an obstructive airway disease (OAD) in primary care.
methodsCross sectional diagnostic study of 219 adult patients attending 10 general practices for the first time with complaints suspicious for OAD. All patients underwent spirometry and structured medical histories were documented. All patients received whole-body plethysmography (WBP) in a lung function laboratory. The reference standard was the Tiffeneau ratio (FEV1/VC) received by the spirometric maneuver during examination with WBP. In the event of inconclusive results, bronchial provocation was performed to determine bronchial hyper-responsiveness (BHR). Asthma was defined as a PC20 fall after inhaling methacholine concentration < or = 16 mg/ml.
results90 (41.1%) patients suffered from asthma, 50 (22.8%) suffered from COPD, 79 (36.1%) had no OAD. The sensitivity for diagnosing airway obstruction in COPD was 92% (95%CI 80-97); specificity was 84% (95%CI 77-89). The positive predictive value (PPV) was 63% (95%CI 51-73); negative predictive value (NPV) was 97% (95%CI 93-99). The sensitivity for diagnosing airway obstruction in asthma was 29% (95%CI 21-39); specificity was 90% (95%CI 81-95). PPV was 77% (95%CI 60-88); NPV was 53% (95%CI 45-61).
conclusionCOPD can be estimated with high diagnostic accuracy using spirometry. It is also possible to rule in asthma with spirometry. However, asthma can not be ruled out only using spirometry. This diagnostic uncertainty leads to an overestimation of asthma presence. Patients with inconclusive spirometric results should be referred for nitric oxide (NO) - measurement and/or bronchial provocation if possible to guarantee accurate diagnosis.
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