Evidence map›Paper›PMID 37072532›Full record

ArticleJournal of general internal medicine2023

Use of the Spirometric "Fixed-Ratio" Underdiagnoses COPD in African-Americans in a Longitudinal Cohort Study.

Elizabeth A Regan, Melissa E Lowe, Barry J Make, Jeffrey L Curtis, Quan Grace Chen, Michael H Cho, James L Crooks, Katherine E Lowe, Carla Wilson, James K O'Brien and 26 more

Open access · bronzeAbstract readComparative StudyMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of general internal medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
1.6field-weighted citation impact, top 16% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 6 citations in OpenAlex.

  1. Review
  2. Article
  3. Article
  4. Testing the Limits: Alternative Definitions of Spirometry Thresholds.Annals of the American Thoracic Society · 2024
    Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

36 authors at 16 institutions in 2 countries.

Elizabeth A ReganDepartment of Medicine, National Jewish Health, Denver, CO, USA. Regane@NJHealth.org.
Melissa E LoweDuke Cancer Center, Biostatistics, Duke University Medical Center, Durham, NC, USA.
Barry J MakeDivision of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, National Jewish Health, Denver, CO, USA.
Jeffrey L CurtisPulmonary & Critical Care Medicine, Department of Internal Medicine, University of Michigan Health System, Ann Arbor, MI, USA.
Quan Grace ChenEdwards Lifesciences, Irvine, CA, USA.
Michael H ChoDepartment of Medicine, Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, MA, USA.
James L CrooksDivision of Biostatistics and Bioinformatics and Department of Immunology and Genomic Medicine, National Jewish Health, Denver, CO, USA.
Katherine E LoweCleveland Clinic Lerner College of Medicine of Case Western Reserve School of Medicine, Cleveland, OH, USA.
Carla WilsonResearch Informatics Services, National Jewish Health, Denver, CO, USA.
James K O'BrienDivision of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, National Jewish Health, Denver, CO, USA.
Gabriela R OatesUniversity of Alabama at Birmingham, Birmingham, AL, USA.
Arianne K BaldomeroPulmonary, Allergy, Critical Care, and Sleep Medicine, University of Minnesota, Minneapolis, MN, USA.
Gregory L KinneyDepartment of Epidemiology, Colorado School of Public Health, Aurora, CO, USA.
Kendra A YoungDepartment of Epidemiology, Colorado School of Public Health, Aurora, CO, USA.
Alejandro A DiazDivision of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Surya P BhattDivision of Pulmonary, Allergy and Critical Care Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
Meredith C McCormackPulmonary and Critical Care, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Nadia N HanselPulmonary and Critical Care, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Victor KimDepartment of Thoracic Medicine and Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, PA, USA.
Nicole E RichmondDepartment of Epidemiology, Colorado School of Public Health, Aurora, CO, USA.
Gloria E WestneyPulmonary and Critical Care Medicine, Morehouse School of Medicine, Atlanta, GA, USA.
Marilyn G ForemanPulmonary and Critical Care Medicine, Morehouse School of Medicine, Atlanta, GA, USA.
Douglas J ConradDepartment of Medicine, University of California San Diego, La Jolla, CA, USA.
Dawn L DeMeoDepartment of Medicine, Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, MA, USA.
Karin F HothDepartment of Psychiatry, University of Iowa, Iowa City, IA, USA.
Hannatu AmazaDepartment of Psychiatry, University of Iowa, Iowa City, IA, USA.
Aparna BalasubramanianPulmonary and Critical Care, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Julia KalletDepartment of Medicine, National Jewish Health, Denver, CO, USA.
Shandi WattsDepartment of Medicine, National Jewish Health, Denver, CO, USA.
Nicola A HananiaPulmonary, Critical Care and Sleep Medicine, Department of Medicine, Baylor College of Medicine, Houston, TX, USA.
John HokansonDepartment of Epidemiology, Colorado School of Public Health, Aurora, CO, USA.
Terri H BeatyDepartment of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
James D CrapoDivision of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, National Jewish Health, Denver, CO, USA.
Edwin K SilvermanDepartment of Medicine, Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, MA, USA.
Richard CasaburiRehabilitation Clinical Trials Center, The Lundquist Institute at Harbor-UCLA Medical Center, Torrance, CA, USA.
Robert WisePulmonary and Critical Care, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
National Jewish Health · USColorado School of Public Health · USJohns Hopkins University · USBrigham and Women's Hospital · USMorehouse School of Medicine · USUniversity of Alabama at Birmingham · USUniversity of Iowa · USBaylor College of Medicine · USCleveland Clinic Lerner College of Medicine · USDuke Medical Center · USEdwards Lifesciences (United States) · USTemple University · USUCLA Medical Center · USUniversity of California San Diego · USUniversity of Minnesota · USVeterans Health Administration · US

Funding

Genetic Epidemiology of COPDU01HL089897 · NHLBI · NATIONAL JEWISH HEALTH · PI CRAPO, JAMES D · 2007 to 2021
$56.9M
Genetic Epidemiology of COPDU01HL089856 · NHLBI · BRIGHAM AND WOMEN'S HOSPITAL · PI SILVERMAN, EDWIN K · 2007 to 2021
$20.7M
Clinical Implications, Genomics, and Transcriptions of Mucus Plugging in SmokersR01HL149861 · NHLBI · BRIGHAM AND WOMEN'S HOSPITAL · PI CHO, MICHAEL H., DIAZ, ALEJANDRO · 2020 to 2023
$3.2M
Understanding airway mucus dysfunction in population-based studiesR01HL164824 · NHLBI · BRIGHAM AND WOMEN'S HOSPITAL · PI DIAZ, ALEJANDRO · 2022 to 2025
$2.7M
Pulmonary Vascular Disease as a Contributor to Respiratory Morbidity in Chronic Obstructive Pulmonary DiseaseK23HL153778 · NHLBI · JOHNS HOPKINS UNIVERSITY · PI Aparna Balasubramanian · 2022 to 2026
$991k
NHLBI NIH HHS K23 HL153778NHLBI NIH HHS R01 HL149861NHLBI NIH HHS R01 HL164824NHLBI NIH HHS U01 HL089856NHLBI NIH HHS U01 HL089897
6 · The paper itself

Abstract

backgroundCOPD diagnosis is tightly linked to the fixed-ratio spirometry criteria of FEV

objectiveCompare COPD diagnosis by fixed-ratio with findings and outcomes by race.

designGenetic Epidemiology of COPD (COPDGene) (2007-present), cross-sectional comparing non-Hispanic white (NHW) and African-American (AA) participants for COPD diagnosis, manifestations, and outcomes.

settingMulticenter, longitudinal US cohort study.

participantsCurrent or former smokers with ≥ 10-pack-year smoking history enrolled at 21 clinical centers including over-sampling of participants with known COPD and AA. Exclusions were pre-existing non-COPD lung disease, except for a history of asthma. MEASUREMENTS: Subject diagnosis by conventional criteria. Mortality, imaging, respiratory symptoms, function, and socioeconomic characteristics, including area deprivation index (ADI). Matched analysis (age, sex, and smoking status) of AA vs. NHW within participants without diagnosed COPD (GOLD 0; FEV

resultsUsing the fixed ratio, 70% of AA (n = 3366) were classified as non-COPD, versus 49% of NHW (n = 6766). AA smokers were younger (55 vs. 62 years), more often current smoking (80% vs. 39%), with fewer pack-years but similar 12-year mortality. Density distribution plots for FEV LIMITATIONS: Lack of an alternative diagnostic metric for comparison.

conclusionsThe fixed-ratio spirometric criteria for COPD underdiagnosed potential COPD in AA participants when compared to broader diagnostic criteria. Disproportionate reductions in FVC relative to FEV

Indexed as

Pulmonary Disease, Chronic ObstructiveBlack or African AmericanCohort StudiesCross-Sectional StudiesForced Expiratory VolumeHumansLongitudinal StudiesMiddle AgedSmokingSpirometryVital CapacityWhiteCOPDdeprivationdiagnosisfixed ratiospirometry

Identifiers

PMID37072532
PMCPMC10593702
OpenAlexW4366251551

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.