{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T13:35:17Z","timestamp":1767792917906,"version":"3.49.0"},"reference-count":29,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2025,7,13]],"date-time":"2025-07-13T00:00:00Z","timestamp":1752364800000},"content-version":"unspecified","delay-in-days":12,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000265","name":"Medical Research Council","doi-asserted-by":"publisher","award":["MR\/R011192\/1"],"award-info":[{"award-number":["MR\/R011192\/1"]}],"id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100010269","name":"Wellcome Trust","doi-asserted-by":"publisher","award":["085790\/Z\/08\/Z"],"award-info":[{"award-number":["085790\/Z\/08\/Z"]}],"id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open Resp Res"],"accepted":{"date-parts":[[2025,6,20]]},"published-print":{"date-parts":[[2025,7]]},"abstract":"\n Introduction<\/jats:title>\n \n We investigated whether the forced expiratory volume in 6 s (FEV\n 6<\/jats:sub>\n ) can be used as a surrogate for the forced vital capacity (FVC).\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n The Burden of Obstructive Lung Disease is a multinational cohort study. At baseline, data were collected from adults, aged 40 years or older, from 41 sites across 34 countries. Participants from 18 sites were followed-up after a median of 8.3 years. Participants who completed the study core questionnaire and had acceptable post-bronchodilator spirometry were included. We performed receiver operating characteristic analyses to measure the ability of FEV\n 1<\/jats:sub>\n \/FEV\n 6<\/jats:sub>\n less than the lower limit of normal (LLN) to correctly classify FEV\n 1<\/jats:sub>\n \/FVC less than the LLN, and FEV\n 6<\/jats:sub>\n less than the LLN to correctly classify FVC less than the LLN. We used multilevel regression analyses to assess the association of discordant measurements with respiratory symptoms, quality of life and lung function decline.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n At baseline, 28\u2008604 participants were included. 53% were female (15 060). 10% (2876) had chronic airflow obstruction for FEV\n 1<\/jats:sub>\n \/FVC, compared with 9% (2704) for FEV\n 1<\/jats:sub>\n \/FEV\n 6<\/jats:sub>\n . 37% (10 637) had spirometric restriction for FVC, compared with 35% (9978) for FEV\n 6<\/jats:sub>\n . The FEV\n 1<\/jats:sub>\n \/FEV\n 6<\/jats:sub>\n had excellent accuracy in identifying FEV\n 1<\/jats:sub>\n \/FVC less than the LLN (area under the curve (AUC): 0.90, 95%\u2009CI, 0.89 to 0.91, \u03ba coefficient 0.82). The FEV\n 6<\/jats:sub>\n also had excellent agreement in identifying FVC less than the LLN (AUC: 0.95, 95%\u2009CI, 0.94 to 0.95, \u03ba coefficient 0.90). Discordant reductions in FEV\n 1<\/jats:sub>\n \/FEV\n 6<\/jats:sub>\n (1%, 345) and FEV\n 6<\/jats:sub>\n (1%, 309) were associated with greater odds of having respiratory symptoms and a lower physical quality of life. 3870 participants were followed up. Those with discordant reductions in FEV\n 1<\/jats:sub>\n \/FEV\n 6<\/jats:sub>\n and FEV\n 6<\/jats:sub>\n were more likely to have chronic airflow obstruction and spirometric restriction at follow-up.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n There is strong agreement between the FVC and FEV\n 6<\/jats:sub>\n in the identification of chronic airflow obstruction and spirometric restriction.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1136\/bmjresp-2024-002355","type":"journal-article","created":{"date-parts":[[2025,7,14]],"date-time":"2025-07-14T03:45:18Z","timestamp":1752464718000},"page":"e002355","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Concordance between FVC and FEV\n 6<\/sub>\n for identifying chronic airflow obstruction and spirometric restriction in the Burden of Obstructive Lung Disease (BOLD) study"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5573-4413","authenticated-orcid":false,"given":"Ben","family":"Knox-Brown","sequence":"first","affiliation":[{"name":"Imperial College London National Heart and Lung Institute, London, UK"},{"name":"Cambridge Respiratory Physiology, Royal Papworth and Cambridge University Hospitals NHS FT, Cambridge, UK"}]},{"given":"James","family":"Potts","sequence":"additional","affiliation":[{"name":"National Heart and Lung Institute, Imperial College London, London, UK"}]},{"given":"Frits M E","family":"Franssen","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands"}]},{"given":"Rune","family":"Nielsen","sequence":"additional","affiliation":[{"name":"Department of Thoracic Medicine, Haukeland University Hospital, Bergen, Norway"},{"name":"Department of Thoracic Medicine, Haukeland University Hospital, Bergen, Norway"}]},{"given":"Meriam","family":"Denguezli","sequence":"additional","affiliation":[{"name":"Facult\u00e9 de M\u00e9decine de Sousse, Universit\u00e9 de Sousse, Sousse, Tunisia"}]},{"given":"Anders \u00d8rskov","family":"Rotevatn","sequence":"additional","affiliation":[{"name":"Department of Thoracic Medicine, Haukeland University Hospital, Bergen, Norway"},{"name":"Department of Clinical Science, University of Bergen, Bergen, Norway"}]},{"given":"Sanjay K","family":"Juvekar","sequence":"additional","affiliation":[{"name":"Vadu Rural Health Program, KEM Hospital Pune Research Centre, Pune, Maharashtra, India"},{"name":"Dr D Y Patil Medical College Hospital and Research Centre, Pune, Maharashtra, India"}]},{"given":"Hamid Hacene","family":"Cherkaski","sequence":"additional","affiliation":[{"name":"Department of Pneumology, University Badji Mokhtar of Annaba, Annaba, Algeria"}]},{"given":"Michael","family":"Studnicka","sequence":"additional","affiliation":[{"name":"Department Respiratory Disease, Paracelsus Medical University Salzburg, Salzburg, Austria"}]},{"given":"Karl Peter","family":"Sylvester","sequence":"additional","affiliation":[{"name":"Cambridge Respiratory Physiology, Royal Papworth and Cambridge University Hospitals NHS FT, Cambridge, UK"}]},{"given":"Kevin","family":"Mortimer","sequence":"additional","affiliation":[{"name":"University of Cambridge, Cambridge, UK"},{"name":"Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK"}]},{"given":"Eric D","family":"Bateman","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Cape Town, Rondebosch, South Africa"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5093-6980","authenticated-orcid":false,"given":"Christer","family":"Janson","sequence":"additional","affiliation":[{"name":"Dep of Medical Sciences: Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4098-7765","authenticated-orcid":false,"given":"Andrei","family":"Malinovschi","sequence":"additional","affiliation":[{"name":"Dep of Medical Sciences: Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden"}]},{"given":"Terence","family":"Seemungal","sequence":"additional","affiliation":[{"name":"The University of the West Indies St Augustine Campus, St Augustine, Trinidad and Tobago"}]},{"given":"Parvaiz","family":"Koul","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India"}]},{"given":"David","family":"Mannino","sequence":"additional","affiliation":[{"name":"University of Kentucky, Lexington, Kentucky, USA"},{"name":"COPD Foundation, Miami, Florida, USA"}]},{"given":"Padukudru Anand","family":"Mahesh","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, JSS Medical College, Mysuru, Karnataka, India"}]},{"given":"Rain","family":"Jogi","sequence":"additional","affiliation":[{"name":"Lung Clinic, Tartu University Hospital, Tartu, Estonia"}]},{"given":"Filip","family":"Mejza","sequence":"additional","affiliation":[{"name":"Centre for Evidence Based Medicine, 2nd Department of Internal Medicine, Jagiellonian University Medical College, Krakow, Poland"}]},{"given":"Mohammed","family":"Al Ghobain","sequence":"additional","affiliation":[{"name":"King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia"},{"name":"King Abdullah International Medical Research Center, Riyadh, Saudi Arabia"}]},{"given":"Stefanni Nonna M","family":"Paraguas","sequence":"additional","affiliation":[{"name":"Philippine College of Chest Physicians, Manila, Philippines"}]},{"given":"Tobias","family":"Welte","sequence":"additional","affiliation":[{"name":"Department of Pneumology, Hannover Medical School, Hannover, Germany"}]},{"given":"Emiel","family":"Wouters","sequence":"additional","affiliation":[{"name":"Medical Faculty, Sigmund Freud Private University Vienna, Vienna, Austria"},{"name":"Maastricht University Medical Centre+, Maastricht, The Netherlands"}]},{"given":"Thorarinn","family":"Gislason","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Iceland, Reykjavik, Iceland"},{"name":"Department of Sleep, Landspitali, Reykjavik, Iceland"}]},{"given":"Imed","family":"Harrabi","sequence":"additional","affiliation":[{"name":"Ibn El Jazzar Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia"}]},{"given":"Herm\u00ednia","family":"Dias","sequence":"additional","affiliation":[{"name":"Escola Superior de Tecnologia da Sa\u00fade de Lisboa, Lisbon Polytechnic Institute Lisbon School of Health Technology, Lisboa, Portugal"}]},{"given":"Daniel O","family":"Obaseki","sequence":"additional","affiliation":[{"name":"Department of Medicine, Obafemi Awolowo University, Ile-Ife, Nigeria"},{"name":"Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada"}]},{"given":"Ali","family":"Kocabas","sequence":"additional","affiliation":[{"name":"Department of Chest Diseases, \u00c7ukuova University, Adana, Turkey"}]},{"given":"Cristina","family":"Barbara","sequence":"additional","affiliation":[{"name":"Institute of Environmental Health, University of Lisbon, Lisboa, Portugal"}]},{"given":"Joao","family":"Cardoso","sequence":"additional","affiliation":[{"name":"Centro Hospitalar Universit\u00e1rio Lisboa Norte EPE Servi\u00e7o de Pneumologia, Lisboa, Portugal"}]},{"given":"Dhiraj","family":"Agarwal","sequence":"additional","affiliation":[{"name":"Vadu Rural Health Program, KEM Hospital Pune Research Centre, Pune, Maharashtra, India"}]},{"given":"Asaad Ahmed","family":"Nafees","sequence":"additional","affiliation":[{"name":"Department of Community Health Sciences, The Aga Khan University, Karachi, Pakistan"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4403-2878","authenticated-orcid":false,"given":"Fatima","family":"Rodrigues","sequence":"additional","affiliation":[{"name":"Institute of Environmental Health, University of Lisbon, Lisboa, Portugal"},{"name":"Centro Hospitalar Universit\u00e1rio Lisboa Norte EPE Servi\u00e7o de Pneumologia, Lisboa, Portugal"}]},{"given":"Vanessa","family":"Garcia-Larsen","sequence":"additional","affiliation":[{"name":"Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA"}]},{"given":"Gregory E","family":"Erhabor","sequence":"additional","affiliation":[{"name":"Obafemi Awolowo University, Ile-Ife, Nigeria"}]},{"given":"Li-Cher","family":"Loh","sequence":"additional","affiliation":[{"name":"Royal College of Surgeons in Ireland, University College Dublin Malaysia Campus, Penang, Malaysia"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0369-9449","authenticated-orcid":false,"given":"Andre F 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