title: The value of periodic spirometry for early recognition of long-term excessive lung function decline in individuals.
abstract: OBJECTIVE
  To establish the value of workplace spirometry monitoring methods for early recognition of long-term excessive lung function decline in individuals.
  
  
  METHODS
  Sensitivity, specificity, and positive likelihood ratio were calculated to determine the predictive value of the linear regression slope and limits of longitudinal decline for early prediction of long-term excessive forced expiratory volume in 1 second (FEV1) decline (> 90 mL/yr established over 9 to 11 years) in ongoing spirometry monitoring programs (firefighters and construction workers) and a historical program (paper-pulp mill workers). The longitudinal limits account for the expected FEV1 within-person variability.
  
  
  RESULTS
  The longitudinal limits achieved clinical "usefulness" (positive likelihood ratio 10 or higher) from the fourth to fifth year of follow-up, whereas the linear regression slope was less useful. The usefulness depended on data precision and measurement frequency.
  
  
  CONCLUSIONS
  The limits of longitudinal decline are more useful for early recognition of long-term excessive FEV1 decline than the linear regression slope.
authors.affiliation: Division of Respiratory Disease Studies, National Institute for Occupational Safety and Health, Morgantown, W Va 26505, USA. ehnizdo@cdc.gov
authors.forename: Eva
authors.initials: E
authors.lastname: Hnizdo
mesh_terms: D000328:Adult; D060389:Construction Industry; D018450:Disease Progression; D061388:Firefighters; D005500:Follow-Up Studies; D005541:Forced Expiratory Volume; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000175:diagnosis* / Q000503:physiopathology; D009786:Occupational Health Services / Q000379:methods*; D011237:Predictive Value of Tests; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis* / Q000503:physiopathology; D012680:Sensitivity and Specificity; D013147:Spirometry