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The Rational Clinical Examination
David L. Simel, Drummond Rennie
Airflow Limitation
David L. Simel, Sheri Keitz
Make the Diagnosis: Airflow Limitation


Topics Discussed: airway obstruction, chronic obstructive airway disease, criterion standard comparisons (diagnostic tests), likelihood ratio, make the diagnosis, prior probability

Excerpt: "A systematic review identified 32 sources of information from studies done worldwide on the prevalence of obstructive airways disease.13 Nine of the 32 studies used a spirometric reference standard, similar to what is advocated for clinical practice; 8 of these had data that allowed us to compare the overall prevalence and sex-specific prevalence. The summary overall prevalence was 7.1% (95% CI, 5.2%-9.3%). Men (11%; 95% CI, 8.5%-14%) had about twice the rate as women (6%; 95% CI, 3%-10%) (see Table 13-7). ..."
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