Article Figures & Data
Figures
- Figure 1
Measurement points for laryngeal height.
Maximum larynx height is measured from the suprasternal notch to the top of the thyroid cartilage at the end of expiration.
Adapted with permission from Casado VV. Examen físico del aparato respiratorio. En: Casado VV, Cordón GF, García VG. Manual de Exploración Física: Basado en la Persona, en el Síntoma y en la Evidencia. Barcelona: semFYC; 2012:78.
Tables
Variable Value Demographic characteristic Mean age, y (SD) 53.7 (7.6) Women, % 57.9 Normal BMI (18.5–24.9) 47.7 BMI 25–29.9 33 BMI ≥30 19.3 Men, % 42.1 Normal BMI (18.5–24.9), % 15.7 BMI 25–29.9, % 54.2 BMI ≥30, % 30.1 Mean BMI (SD) 26.6 (4.6) Total current nonsmokers, % 81.6 Ex-smoker 56.3 Male ex-smoker 52.3 Female ex-smoker 47.6 Quit >10 y 72.0 Quit in last 10 y 28.0 Never smoked 35.6 Total smokers, % 18.4 Male 37.2 Female 62.8 Study finding COPD prevalence, % 6.0 Male 64.3 Female 35.7 Mild 36.4 Moderate 36.4 Severe 27.3 Maximum LH, cm (95% CI) Mean LH 6.33 (6.17–6.49) Male 6.41 (6.25–6.57) Female 6.26 (6.10–6.42) COPD, female 5.78 (5.52–6.04) Non-COPD, female 6.28 (6.13–6.43) COPD, male 6.6 (6.36–6.83) Non-COPD, male 6.4 (6.24–6.56) LH ≤4 cm, % 4.5 (1.86–7.14) -
BMI = body mass index; COPD = chronic obstructive pulmonary disease; LH = laryngeal height.
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- Table 2
Intrinsic Validity and Likelihood Ratios of Laryngeal Height, Lung Function Questionnaire, and COPD Diagnostic Questionnaire
Measurement Sensitivity % (CI 95%) Specificity % (CI 95%) LR+ (95% CI) LR– (95% CI) LH 21 (0–43) 96 9(3–99) 5.21 (1.59–17.14) 0.82 (0.62–1.08) LHa 18 (5–41) 96 (94–99) 4.98 (1.2–20.72) 0.85 (0.64–1.12) LFQ 93 (79–106) 71 (65–77) 3.18 (0.65–4.09) 0.10 (0.02–0.67) LFQa 91 (74–108) 70 (65–77) 3.11 (2.36–4.11) 0.13 (0.02–0.83) COPD DQ 36 (11–61) 93 (89–96) 4.89 (2.1–11.4) 0.69 (0.47–1.03) COPD DQa 18 (5–41) 93 (89–96) 2.49 (0.62–9.5) 0.88 (0.67–0.17) LH + LFQ 75 (33–117) 97 (95–100) 29.06 (9.48–89.13) 0.26 (0.05–1.4) -
COPD = chronic obstructive pulmonary disease ; DQ = diagnostic questionnaire; FEC = forced vital capacity; FEV1 = forced expiratory volume in 1 second;LFQ = Lung Function Questionnaire; LH = laryngeal height; LR− = negative likelihood ratio; LR+ = positive likelihood ratio.
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↵a Excluding patients with previously diagnosed COPD (FEV1/FVC) <0.7.
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Supplemental Table
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The Article in Brief
Laryngeal Measurements and Diagnostic Tools for Diagnosis of Chronic Obstructive Pulmonary Disease
Veronica Casado , and colleagues
Background Laryngeal height is considered a diagnostic sign of chronic obstructive pulmonary disease (COPD). Although examinations to screen and diagnose COPD have been found valid, research on exploratory tests is scarce. This study set out to evaluate sensitivity, specificity, and positive and negative likelihood ratios of maximum laryngeal height, lung function questionnaire, and COPD diagnostic questionnaire for screening and diagnosis of primary care patients.
What This Study Found The combination of laryngeal height measurement and a lung function questionnaire is useful for screening for COPD. Combining a maximum laryngeal height of less than 4 cm with lung function questionnaire findings of less than 18 yielded a sensitivity of 76 percent, specificity of 97 percent, a positive likelihood ratio of 29.06 and a negative likelihood ratio of 0.26.
Implications
- These findings, the authors conclude, suggest that combining Lung Function Questionnaire and laryngeal height can help to confirm or rule out COPD.
