Prospectus, December 18, 1974

REID IS LANDSLIDE VEEP VICTOR: MANDEL, PFAAB, HEDRON ALSO ASSUME OFFICE; Nutritional Labeling To Become Law Jan. 1; Boneyard Hassle May Be Nearing An End; New Debaters Impressive At Greenville; Vets\u27 Benefits Slow In Arriving (Again); The Sky Is Falling, The Sky...; ISU Announces 18 Scholarships For Top JC Applicants; Bouncing Bob Bonanza; Support Grape Boycott; Christmas Is What You Make It; Saturday On The Mall In Words And Action-Packed Pictures; Keeping Our Share; The Short Circuit; The Strange Case Of Del Boyd; The Kaleidoscope; A Column By And For Women; True Happenings; essay; letters; Peace On Earth?; \u27Silver Morning\u27 Rankin\u27s Return A Culmination; Share This One With A Friend; \u27War Child\u27 Return Of The Mutant Minstrel; Young Volunteers Here Working With The Aged; Blues At Ruby Gulch, Advice Well Taken; Rec Music Sponsors Christmas Singalong; Classified Ads; Ski Trip Leaves In Mid-January; Bank Offers PC License Plates; Student Association Rips State Pot Laws; Electronics Association Sponsors \u27Ham\u27 Giveaway; Cobra Offense Improving ; PC Cagers 5-0; Intramural Basketball Scores; Lee Oswald - Killer or Patsy?; Schoolboy All-Stater Davidson Joins Cagers; Fast Freddy\u27s Football Forecasthttps://spark.parkland.edu/prospectus_1974/1000/thumbnail.jp

Can spirometric norms be set using pre- or post- bronchodilator test results in older people?

Background: Chronic Obstructive Pulmonary Disease (COPD) is defined by post-bronchodilator spirometry. Data on “normal values” come predominantly from pre-bronchodilator spirometry. The effects of this on diagnosis are unknown. Methods: Lower limits of normal (LLN) were estimated from “normal” participants in the Burden of Obstructive Lung Disease (BOLD) programme. Values separately derived using pre- and post-bronchodilator spirometry were compared. Sensitivity and specificity of criteria derived from pre-bronchodilator spirometry and pre-bronchodilator spirometry adjusted by a constant were assessed in the remaining population. The “gold standard” was the LLN for the post-bronchodilator spirometry in the “normal population”. For FEV1/FVC, sensitivity and specificity of criteria were also assessed when a fixed value of < 70% was used rather than LLN. Results: Of 6,600 participants with full data, 1,354 were defined as “normal”. Mean differences between pre- and post- bronchodilator measurements were small and the Bland-Altman plots showed no association between difference and mean value. Compared with using the gold standard, however, tests using pre-bronchodilator spirometry had a sensitivity and specificity of detecting a low FEV1 of 78.4% and 100%, a low FVC of 99.8% and 99.1% and a low FEV1/FVC ratio of 65% and 100%. Adjusting this by a constant improved the sensitivity without substantially altering the specificity for FEV1 (99%, 99.8%), FVC (97.4%, 99.9%) and FEV1/FVC (98.7%, 99.5%). Conclusions: Using pre-bronchodilator spirometry to derive norms for lung function reduces sensitivity compared to a post-bronchodilator gold standard. Adjustment of these values by a constant can improve validity of the test