title: A forced expiratory flow at 25-75% value <65% of predicted should be considered abnormal: a real-world, cross-sectional study.
abstract: Forced expiratory volume in 1 second (FEV1) is considered an important parameter for asthma diagnosis and follow-up. However, it has been proposed that forced expiratory flow at 25-75% (FEF(25-75)) could be more sensitive than FEV1 to detect slight airways obstruction. In this regard, a cutoff FEF(25-75) value has been recently established in a group of asthmatic children: FEF(25-75) < 65% of predicted has been considered impaired. However, the considered population was specifically selected. Therefore, the aim of the present study was to confirm an FEF(25-75) cutoff value in a large cohort of asthmatic children. Seven hundred allergic children (493 male subjects; median age, 11 years) with controlled and partly controlled asthma were evaluated by performing spirometry and skin-prick tests. Three hundred thirteen (44.7%) patients had FEF(25-75%) values of <65% of predicted. Two predictors were significantly associated with impaired FEF(25-75) values: (i) sensitization to perennial allergens (adjusted odds ratio [OR(Adj)], 3.4) and (ii) FEV(1) ≤ 86% of predicted (OR(Adj), 3.8). This study, conducted in real life, could suggest that FEF(25-75) value of <65% of predicted may be considered abnormal.
authors.affiliation: Istituto di Ricovero e Cura a Carattere Scientifico-Azienda Ospedaliera Universitaria San Martino, Genoa, Italy. gio.cip@libero.it
authors.forename: Giorgio
authors.initials: G
authors.lastname: Ciprandi
authors.forename: Michele
authors.initials: M
authors.lastname: Capasso
authors.forename: Mariangela
authors.initials: M
authors.lastname: Tosca
authors.forename: Carmelo
authors.initials: C
authors.lastname: Salpietro
authors.forename: Annamaria
authors.initials: A
authors.lastname: Salpietro
authors.forename: Gianluigi
authors.initials: G
authors.lastname: Marseglia
authors.forename: Mario
authors.initials: M
authors.lastname: La Rosa
mesh_terms: D001249:Asthma / Q000175:diagnosis* / Q000453:epidemiology*; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007114:Immunization; D007558:Italy; D008297:Male; D008450:Maximal Midexpiratory Flow Rate; D011237:Predictive Value of Tests; D011379:Prognosis; D012015:Reference Standards; D012680:Sensitivity and Specificity; D012882:Skin Tests; D013147:Spirometry / Q000379:methods