Is
Peak Expiratory Flow (PEF) a Good Indicator for Assessing Airway
Obstruction in Waterpipe Smokers?
Ghada
Hamada, Ghada Radwan,Mohamed
Zakaria, Mostafa Mohamed, Maged Setouhy,Ebenezer Israel
Egyptian
Smoking Prevention Research Institute (ESPRI)1, Ain Shams University
School of Medicine 2, Mania University School of Medicine 3,
Ministry
of Health 4 , Cairo University School of Medicine 5 and University
of Maryland 6.
Abstract
The use of Peak
Expiratory Flow(PEF) measurements for population based measurements to
study waterpipe smoking induced pulmonary dysfunction needs to be
validated, This study assesses the usefulness of PEF measurements in
waterpipe smokers.
Methods:
358 cigarette
smokers, 84 waterpipe smokers (Mean +S.D duration of smoking
18.8+11.5, 13.0+12.5, respectively). and 32 controls were tested for
FEV1 and PEF using an expiratory flow/volume curve. The percent of
predicted of FEV1 value of <0.8 and PEF value of <0.8 were
calculated. Sensitivity , specificity , positive and negative
predictive values were calculated using FEV1 as the gold standard
against which the PEF was measured as the screening test for controls,
cigarette smokers and waterpipe smokers.
Results:
Sensitivity for the
test was 86%, 78%, 93% for controls , cigarette smokers and waterpipe
smokers respectively. Specificity for PEF was 84%,70%, 37% for
controls , cigarette smokers and waterpipe smokers respectively.
Positive predictive value for PEF was 60%, 48%, 33% for controls,
cigarette smokers and waterpipe smokers respectively. Negative
predictive value for PEF was 96%, ,90% and 98% for controls, cigarette
smokers and waterpipe smokers respectively. The overall accuracy of
PEF was only 68%.for waterpipe smokers.
Conclusions:
PEF does not have
adequate validity as a screening tool for waterpipe smoking induced
obstruction for use in community surveys.
