Logistic Regression Model for Prediction of Airway Reversibility Using Peak Expiratory Flow

Background: Using peak expiratory flow (PEF) as an alternative to spirometry parameters (FEV1 and FVC), for detection of airway reversibility in diseases with airflow limitation is challenging. We developed logistic regression (LR) model to discriminate bronchodilator responsiveness (BDR) and then compared the results of models with a performance of > 18%, > 20%, and > 22% increase in ?PEF% (PEF change relative to baseline), as a predictor for bronchodilator responsiveness (BDR). Materials and Methods: PEF measurements of pre-bronchodilator, postbronchodilator and ?PEF% of 90 patients with asthma (44) and chronic obstructive pulmonary disease (46) were used as inputs of model and the output was presence or absence of the BDR. Results: Although ?PEF% was a poor discriminator, LR model could improve the accuracy of BDR. Sensitivity, specificity, positive predictive value, and negative predictive value of LR were 68.89%, 67.27%, 71.43%, and 78.72%, respectively. Conclusion: The LR is a reliable method that can be used clinically to predict BDR based on PEF measurements.