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Smoking, age, and laryngeal height predicted obstructive airway disease in adults

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 QUESTION: How accurate are the clinical examination and patient history in the diagnosis of obstructive airway disease (OAD)?


Blinded comparison of items from the clinical examination and patient history (self reported OAD, smoking history, wheezing on auscultation, maximum and minimum laryngeal height, and laryngeal descent) with spirometric results (FEV1 and FEV1–FVC ratio 5th centile).


20 investigator groups in primary, secondary, and tertiary care centres in 14 countries.


332 patients were recruited, and 309 (mean age 56 y, 57% men, 89% white) were included in the analysis. Patients were recruited so that approximately one third had confirmed OAD, one third had suspected OAD, and one third had no evidence of OAD. Exclusion criteria were reversible airway obstruction, terminal illness, age <18 years, severe respiratory distress, or inability …

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