Comparison of the variability of the annual rates of change in FEV<sub>1</sub> determined from serial measurements of the pre- versus post-bronchodilator FEV<sub>1</sub> over 5 years in mild to moderate COPD: Results of the lung health study
<p>Abstract</p> <p>Background</p> <p>The impact of interventions on the progressive course of COPD is currently assessed by the slope of the annual decline in FEV<sub>1</sub> determined from serial measurements of the post-, in preference to the pre-, bronch...
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| Format: | Article |
| Language: | English |
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BMC
2012-08-01
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| Series: | Respiratory Research |
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| Online Access: | http://respiratory-research.com/content/13/1/70 |
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| author | Tashkin Donald P Wang He-Jing Halpin David Kleerup Eric C Connett John Li Ning Elashoff Robert |
| author_facet | Tashkin Donald P Wang He-Jing Halpin David Kleerup Eric C Connett John Li Ning Elashoff Robert |
| author_sort | Tashkin Donald P |
| collection | DOAJ |
| description | <p>Abstract</p> <p>Background</p> <p>The impact of interventions on the progressive course of COPD is currently assessed by the slope of the annual decline in FEV<sub>1</sub> determined from serial measurements of the post-, in preference to the pre-, bronchodilator FEV<sub>1</sub>. We therefore compared the yearly slope and the variability of the slope of the pre- versus the post-bronchodilator FEV<sub>1</sub> in men and women with mild to moderate COPD who participated in the 5-year Lung Health Study (LHS).</p> <p>Methods</p> <p>Data were analyzed from 4484 of the 5887 LHS participants who had measurements of pre- and post-bronchodilator FEV<sub>1</sub> at baseline (screening visit 2) and all five annual visits. The annual rate of decline in FEV<sub>1</sub> (±SE) measured pre- and post-bronchodilator from the first to the fifth annual visit was estimated separately using a random coefficient model adjusted for relevant covariates. Analyses were performed separately within each of the three randomized intervention groups. In addition, individual rates of decline in pre- and post-bronchodilator FEV<sub>1</sub> were also determined for each participant. Furthermore, sample sizes were estimated for determining the significance of differences in slopes of decline between different interventions using pre- versus post-bronchodilator measurements.</p> <p>Results</p> <p>Within each intervention group, mean adjusted and unadjusted slope estimates were slightly higher for the pre- than the post-bronchodilator FEV<sub>1</sub> (range of differences 2.6-5.2 ml/yr) and the standard errors around these estimates were only minimally higher for the pre- versus the post-bronchodilator FEV<sub>1</sub> (range 0.05-0.11 ml/yr). Conversely, the standard deviations of the mean FEV<sub>1</sub> determined at each annual visit were consistently slightly higher (range of differences 0.011 to 0.035 L) for the post- compared to the pre-bronchodilator FEV<sub>1</sub>. Within each group, the proportion of individual participants with a statistically significant slope was similar (varying by only 1.4 to 2.7%) comparing the estimates from the pre- versus the post-bronchodilator FEV<sub>1</sub>. However, sample size estimates were slightly higher when the pre- compared to the post-bronchodilator value was used to determine the significance of specified differences in slopes between interventions.</p> <p>Conclusion</p> <p>Serial measurements of the pre-bronchodilator FEV<sub>1</sub> are generally sufficient for comparing the impact of different interventions on the annual rate of change in FEV<sub>1</sub>.</p> |
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| spelling | doaj.art-8d20cb0ebda54b4f9591f17af5e8a6fe2022-12-22T01:10:13ZengBMCRespiratory Research1465-99212012-08-011317010.1186/1465-9921-13-70Comparison of the variability of the annual rates of change in FEV<sub>1</sub> determined from serial measurements of the pre- versus post-bronchodilator FEV<sub>1</sub> over 5 years in mild to moderate COPD: Results of the lung health studyTashkin Donald PWang He-JingHalpin DavidKleerup Eric CConnett JohnLi NingElashoff Robert<p>Abstract</p> <p>Background</p> <p>The impact of interventions on the progressive course of COPD is currently assessed by the slope of the annual decline in FEV<sub>1</sub> determined from serial measurements of the post-, in preference to the pre-, bronchodilator FEV<sub>1</sub>. We therefore compared the yearly slope and the variability of the slope of the pre- versus the post-bronchodilator FEV<sub>1</sub> in men and women with mild to moderate COPD who participated in the 5-year Lung Health Study (LHS).</p> <p>Methods</p> <p>Data were analyzed from 4484 of the 5887 LHS participants who had measurements of pre- and post-bronchodilator FEV<sub>1</sub> at baseline (screening visit 2) and all five annual visits. The annual rate of decline in FEV<sub>1</sub> (±SE) measured pre- and post-bronchodilator from the first to the fifth annual visit was estimated separately using a random coefficient model adjusted for relevant covariates. Analyses were performed separately within each of the three randomized intervention groups. In addition, individual rates of decline in pre- and post-bronchodilator FEV<sub>1</sub> were also determined for each participant. Furthermore, sample sizes were estimated for determining the significance of differences in slopes of decline between different interventions using pre- versus post-bronchodilator measurements.</p> <p>Results</p> <p>Within each intervention group, mean adjusted and unadjusted slope estimates were slightly higher for the pre- than the post-bronchodilator FEV<sub>1</sub> (range of differences 2.6-5.2 ml/yr) and the standard errors around these estimates were only minimally higher for the pre- versus the post-bronchodilator FEV<sub>1</sub> (range 0.05-0.11 ml/yr). Conversely, the standard deviations of the mean FEV<sub>1</sub> determined at each annual visit were consistently slightly higher (range of differences 0.011 to 0.035 L) for the post- compared to the pre-bronchodilator FEV<sub>1</sub>. Within each group, the proportion of individual participants with a statistically significant slope was similar (varying by only 1.4 to 2.7%) comparing the estimates from the pre- versus the post-bronchodilator FEV<sub>1</sub>. However, sample size estimates were slightly higher when the pre- compared to the post-bronchodilator value was used to determine the significance of specified differences in slopes between interventions.</p> <p>Conclusion</p> <p>Serial measurements of the pre-bronchodilator FEV<sub>1</sub> are generally sufficient for comparing the impact of different interventions on the annual rate of change in FEV<sub>1</sub>.</p>http://respiratory-research.com/content/13/1/70FEV<sub>1</sub> declineChronic obstructive pulmonary disease (COPD)Lung health studyPre-bronchodilatorPost-bronchodilator |
| spellingShingle | Tashkin Donald P Wang He-Jing Halpin David Kleerup Eric C Connett John Li Ning Elashoff Robert Comparison of the variability of the annual rates of change in FEV<sub>1</sub> determined from serial measurements of the pre- versus post-bronchodilator FEV<sub>1</sub> over 5 years in mild to moderate COPD: Results of the lung health study Respiratory Research FEV<sub>1</sub> decline Chronic obstructive pulmonary disease (COPD) Lung health study Pre-bronchodilator Post-bronchodilator |
| title | Comparison of the variability of the annual rates of change in FEV<sub>1</sub> determined from serial measurements of the pre- versus post-bronchodilator FEV<sub>1</sub> over 5 years in mild to moderate COPD: Results of the lung health study |
| title_full | Comparison of the variability of the annual rates of change in FEV<sub>1</sub> determined from serial measurements of the pre- versus post-bronchodilator FEV<sub>1</sub> over 5 years in mild to moderate COPD: Results of the lung health study |
| title_fullStr | Comparison of the variability of the annual rates of change in FEV<sub>1</sub> determined from serial measurements of the pre- versus post-bronchodilator FEV<sub>1</sub> over 5 years in mild to moderate COPD: Results of the lung health study |
| title_full_unstemmed | Comparison of the variability of the annual rates of change in FEV<sub>1</sub> determined from serial measurements of the pre- versus post-bronchodilator FEV<sub>1</sub> over 5 years in mild to moderate COPD: Results of the lung health study |
| title_short | Comparison of the variability of the annual rates of change in FEV<sub>1</sub> determined from serial measurements of the pre- versus post-bronchodilator FEV<sub>1</sub> over 5 years in mild to moderate COPD: Results of the lung health study |
| title_sort | comparison of the variability of the annual rates of change in fev sub 1 sub determined from serial measurements of the pre versus post bronchodilator fev sub 1 sub over 5 years in mild to moderate copd results of the lung health study |
| topic | FEV<sub>1</sub> decline Chronic obstructive pulmonary disease (COPD) Lung health study Pre-bronchodilator Post-bronchodilator |
| url | http://respiratory-research.com/content/13/1/70 |
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