{"id":"https://openalex.org/W7223666471","doi":"https://doi.org/10.1186/s12890-026-04830-x","title":"Applying the \u2018expiratory disproportion index\u2019 in the pulmonary clinic as a spirometry-derived screening tool for upper airway obstruction in adults","display_name":"Applying the \u2018expiratory disproportion index\u2019 in the pulmonary clinic as a spirometry-derived screening tool for upper airway obstruction in adults","publication_year":2026,"publication_date":"2026-10-27","ids":{"openalex":"https://openalex.org/W7223666471","doi":"https://doi.org/10.1186/s12890-026-04830-x"},"language":"en","primary_location":{"id":"doi:10.1186/s12890-026-04830-x","doi":"https://doi.org/10.1186/s12890-026-04830-x","is_oa":true,"landing_page_url":"https://doi.org/10.1186/s12890-026-04830-x","pdf_url":null,"source":{"id":"https://openalex.org/S204956882","display_name":"BMC Pulmonary Medicine","issn_l":"1471-2466","issn":["1471-2466"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","dongbi-c","doyens","jufo-1","ki-jl-1","medline","norway-1","oarl","poland-100","russia-white-list-2","vabb-shw"],"host_organization":"https://openalex.org/P4310320256","host_organization_name":"BioMed Central","host_organization_lineage":["https://openalex.org/P4310320256","https://openalex.org/P4310319965"],"host_organization_lineage_names":["BioMed Central","Springer Nature"],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"BMC Pulmonary Medicine","raw_type":"journal-article"},"volume":null,"type":"article","indexed_in":["crossref","doaj"],"open_access":{"is_oa":true,"oa_status":"gold","oa_url":"https://doi.org/10.1186/s12890-026-04830-x","any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5036902752","display_name":"Juli\u00ebtta H. C. Schuering","orcid":"https://orcid.org/0000-0002-9260-6856","observed_orcids":["https://orcid.org/0000-0002-9260-6856"]},"institutions":[{"id":"https://openalex.org/I2800006345","display_name":"Leiden University Medical Center","ror":"https://ror.org/05xvt9f17","country_code":"NL","type":"funder","lineage":["https://openalex.org/I2800006345"]}],"countries":["NL"],"is_corresponding":true,"raw_author_name":"Juli\u00ebtta H.C. Schuering","raw_affiliation_strings":["Department of Otorhinolaryngology-Head and Neck Surgery, Leiden University Medical Center Leiden, Zuid-Holland, The Netherlands"],"raw_orcid":"https://orcid.org/0000-0002-9260-6856","affiliations":[{"raw_affiliation_string":"Department of Otorhinolaryngology-Head and Neck Surgery, Leiden University Medical Center Leiden, Zuid-Holland, The Netherlands","institution_ids":["https://openalex.org/I2800006345"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5159628617","display_name":"Sofie Vugts","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I2800006345","display_name":"Leiden University Medical Center","ror":"https://ror.org/05xvt9f17","country_code":"NL","type":"funder","lineage":["https://openalex.org/I2800006345"]}],"countries":["NL"],"is_corresponding":false,"raw_author_name":"Sofie Vugts","raw_affiliation_strings":["Department of Otorhinolaryngology-Head and Neck Surgery, Leiden University Medical Center Leiden, Zuid-Holland, The Netherlands"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Otorhinolaryngology-Head and Neck Surgery, Leiden University Medical Center Leiden, Zuid-Holland, The Netherlands","institution_ids":["https://openalex.org/I2800006345"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5103912353","display_name":"Maarten K. Ninaber","orcid":"https://orcid.org/0000-0002-8405-3374","observed_orcids":["https://orcid.org/0000-0002-8405-3374"]},"institutions":[{"id":"https://openalex.org/I2800006345","display_name":"Leiden University Medical Center","ror":"https://ror.org/05xvt9f17","country_code":"NL","type":"funder","lineage":["https://openalex.org/I2800006345"]}],"countries":["NL"],"is_corresponding":false,"raw_author_name":"Maarten K. Ninaber","raw_affiliation_strings":["Department of Lung Medicine, Leiden University Medical Center Leiden, Zuid-Holland, The Netherlands"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Lung Medicine, Leiden University Medical Center Leiden, Zuid-Holland, The Netherlands","institution_ids":["https://openalex.org/I2800006345"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5159609304","display_name":"Luuk N.A. Willems","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I2800006345","display_name":"Leiden University Medical Center","ror":"https://ror.org/05xvt9f17","country_code":"NL","type":"funder","lineage":["https://openalex.org/I2800006345"]}],"countries":["NL"],"is_corresponding":false,"raw_author_name":"Luuk N.A. Willems","raw_affiliation_strings":["Department of Lung Medicine, Leiden University Medical Center Leiden, Zuid-Holland, The Netherlands"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Lung Medicine, Leiden University Medical Center Leiden, Zuid-Holland, The Netherlands","institution_ids":["https://openalex.org/I2800006345"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5045756053","display_name":"Peter Paul G. van Benthem","orcid":"https://orcid.org/0000-0002-7946-1912","observed_orcids":["https://orcid.org/0000-0002-7946-1912"]},"institutions":[{"id":"https://openalex.org/I2800006345","display_name":"Leiden University Medical Center","ror":"https://ror.org/05xvt9f17","country_code":"NL","type":"funder","lineage":["https://openalex.org/I2800006345"]}],"countries":["NL"],"is_corresponding":false,"raw_author_name":"Peter Paul G. van Benthem","raw_affiliation_strings":["Department of Otorhinolaryngology-Head and Neck Surgery, Leiden University Medical Center Leiden, Zuid-Holland, The Netherlands"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Otorhinolaryngology-Head and Neck Surgery, Leiden University Medical Center Leiden, Zuid-Holland, The Netherlands","institution_ids":["https://openalex.org/I2800006345"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5062410949","display_name":"Elisabeth V. Sj\u00f6gren","orcid":"https://orcid.org/0000-0001-7990-8510","observed_orcids":["https://orcid.org/0000-0001-7990-8510"]},"institutions":[{"id":"https://openalex.org/I2800006345","display_name":"Leiden University Medical Center","ror":"https://ror.org/05xvt9f17","country_code":"NL","type":"funder","lineage":["https://openalex.org/I2800006345"]}],"countries":["NL"],"is_corresponding":false,"raw_author_name":"Elisabeth V. Sj\u00f6gren","raw_affiliation_strings":["Department of Otorhinolaryngology-Head and Neck Surgery, Leiden University Medical Center Leiden, Zuid-Holland, The Netherlands"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Otorhinolaryngology-Head and Neck Surgery, Leiden University Medical Center Leiden, Zuid-Holland, The Netherlands","institution_ids":["https://openalex.org/I2800006345"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5069392924","display_name":"Antonius P. M. Langeveld","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I2800006345","display_name":"Leiden University Medical Center","ror":"https://ror.org/05xvt9f17","country_code":"NL","type":"funder","lineage":["https://openalex.org/I2800006345"]}],"countries":["NL"],"is_corresponding":false,"raw_author_name":"Antonius P.M. Langeveld","raw_affiliation_strings":["Department of Otorhinolaryngology-Head and Neck Surgery, Leiden University Medical Center Leiden, Zuid-Holland, The Netherlands"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Otorhinolaryngology-Head and Neck Surgery, Leiden University Medical Center Leiden, Zuid-Holland, The Netherlands","institution_ids":["https://openalex.org/I2800006345"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":1,"corresponding_author_ids":["https://openalex.org/A5036902752"],"corresponding_institution_ids":["https://openalex.org/I2800006345"],"apc_list":{"value":3090,"currency":"USD","value_usd":3090},"apc_paid":{"value":3090,"currency":"USD","value_usd":3090},"fwci":0.0,"has_fulltext":false,"cited_by_count":0,"citation_normalized_percentile":{"value":0.8431148,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":null,"issue":null,"first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10143","display_name":"Chronic Obstructive Pulmonary Disease (COPD) Research","score":0.9154999852180481,"subfield":{"id":"https://openalex.org/subfields/2740","display_name":"Pulmonary and Respiratory Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10143","display_name":"Chronic Obstructive Pulmonary Disease (COPD) Research","score":0.9154999852180481,"subfield":{"id":"https://openalex.org/subfields/2740","display_name":"Pulmonary and Respiratory Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10051","display_name":"Asthma and respiratory diseases","score":0.02539999969303608,"subfield":{"id":"https://openalex.org/subfields/2737","display_name":"Physiology (medical)"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T12418","display_name":"Respiratory and Cough-Related Research","score":0.01600000075995922,"subfield":{"id":"https://openalex.org/subfields/2740","display_name":"Pulmonary and Respiratory Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/upper-airway-obstruction","display_name":"upper airway obstruction","score":0.9660000205039978},{"id":"https://openalex.org/keywords/spirometry","display_name":"spirometry","score":0.7279999852180481},{"id":"https://openalex.org/keywords/screening-tool","display_name":"screening tool","score":0.8899999856948853},{"id":"https://openalex.org/keywords/adults","display_name":"adults","score":0.7900000214576721},{"id":"https://openalex.org/keywords/airway-obstruction","display_name":"airway obstruction","score":0.44699999690055847}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.9876999855041504},{"id":"https://openalex.org/C2778333281","wikidata":"https://www.wikidata.org/wiki/Q4330029","display_name":"Airway obstruction","level":3,"score":0.6730999946594238},{"id":"https://openalex.org/C105922876","wikidata":"https://www.wikidata.org/wiki/Q1423981","display_name":"Airway","level":2,"score":0.4090000092983246},{"id":"https://openalex.org/C141071460","wikidata":"https://www.wikidata.org/wiki/Q40821","display_name":"Surgery","level":1,"score":0.3625999987125397},{"id":"https://openalex.org/C2779473830","wikidata":"https://www.wikidata.org/wiki/Q1540899","display_name":"MEDLINE","level":2,"score":0.33970001339912415},{"id":"https://openalex.org/C177713679","wikidata":"https://www.wikidata.org/wiki/Q679690","display_name":"Intensive care medicine","level":1,"score":0.32829999923706055},{"id":"https://openalex.org/C81182388","wikidata":"https://www.wikidata.org/wiki/Q353963","display_name":"Complication","level":2,"score":0.2639999985694885},{"id":"https://openalex.org/C187212893","wikidata":"https://www.wikidata.org/wiki/Q123028","display_name":"Pediatrics","level":1,"score":0.24539999663829803},{"id":"https://openalex.org/C205545832","wikidata":"https://www.wikidata.org/wiki/Q17156455","display_name":"Young adult","level":2,"score":0.243599995970726},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.24240000545978546}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.1186/s12890-026-04830-x","doi":"https://doi.org/10.1186/s12890-026-04830-x","is_oa":true,"landing_page_url":"https://doi.org/10.1186/s12890-026-04830-x","pdf_url":null,"source":{"id":"https://openalex.org/S204956882","display_name":"BMC Pulmonary Medicine","issn_l":"1471-2466","issn":["1471-2466"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","dongbi-c","doyens","jufo-1","ki-jl-1","medline","norway-1","oarl","poland-100","russia-white-list-2","vabb-shw"],"host_organization":"https://openalex.org/P4310320256","host_organization_name":"BioMed Central","host_organization_lineage":["https://openalex.org/P4310320256","https://openalex.org/P4310319965"],"host_organization_lineage_names":["BioMed Central","Springer Nature"],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"BMC Pulmonary Medicine","raw_type":"journal-article"}],"best_oa_location":{"id":"doi:10.1186/s12890-026-04830-x","doi":"https://doi.org/10.1186/s12890-026-04830-x","is_oa":true,"landing_page_url":"https://doi.org/10.1186/s12890-026-04830-x","pdf_url":null,"source":{"id":"https://openalex.org/S204956882","display_name":"BMC Pulmonary Medicine","issn_l":"1471-2466","issn":["1471-2466"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","dongbi-c","doyens","jufo-1","ki-jl-1","medline","norway-1","oarl","poland-100","russia-white-list-2","vabb-shw"],"host_organization":"https://openalex.org/P4310320256","host_organization_name":"BioMed Central","host_organization_lineage":["https://openalex.org/P4310320256","https://openalex.org/P4310319965"],"host_organization_lineage_names":["BioMed Central","Springer Nature"],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"BMC Pulmonary Medicine","raw_type":"journal-article"},"sustainable_development_goals":[{"score":1.0,"display_name":"Good health and well-being","id":"https://metadata.un.org/sdg/3"}],"study_designs":[{"display_name":"Observational Study","id":"https://openalex.org/study-designs/observational-study"}],"awards":[],"funders":[],"has_content":{"pdf":false,"grobid_xml":false},"content_urls":null,"referenced_works_count":0,"referenced_works":[],"related_works":["https://openalex.org/W2776277888","https://openalex.org/W1990122775","https://openalex.org/W2048486148","https://openalex.org/W3211306459","https://openalex.org/W4386219816","https://openalex.org/W4416638597","https://openalex.org/W2051541610","https://openalex.org/W2051147611","https://openalex.org/W1993093709","https://openalex.org/W2153483230"],"abstract_inverted_index":{"Upper":[0],"airway":[1,56,95,156],"obstructions,":[2],"such":[3],"as":[4,49,113,148],"a":[5,23,50,67,114,124],"subglottic":[6],"stenosis,":[7],"are":[8],"often":[9],"not":[10],"recognized":[11],"early":[12],"due":[13],"to":[14,34],"the":[15,36,40,62,73,76,108,111,133,142,145,160],"asthma-like":[16],"symptoms.":[17],"This":[18,105],"delay":[19],"may":[20],"result":[21],"in":[22,58,61,159],"high":[24],"morbidity":[25],"and":[26,75,101,126],"mortality.":[27],"In":[28,66],"this":[29,139],"study,":[30,70],"our":[31],"aim":[32],"was":[33],"evaluate":[35],"clinical":[37,78],"implementation":[38],"of":[39,80,110,121,135,144],"expiratory":[41],"disproportion":[42],"index":[43],"(EDI),":[44],"derived":[45],"from":[46],"standard":[47,115],"spirometry,":[48],"non-invasive":[51,149],"screening":[52,116,150],"method":[53],"for":[54,85,118,152],"upper":[55,94,155],"obstructions":[57,157],"new":[59],"patients":[60,83,91,153],"outpatient":[63,161],"pulmonary":[64,162],"clinic.":[65,163],"retrospective":[68],"cohort":[69],"we":[71],"analysed":[72],"EDI":[74,100,112,146],"subsequent":[77],"course":[79],"244":[81,88],"consecutive":[82],"referred":[84],"spirometry.":[86],"Of":[87],"patients,":[89],"3":[90],"with":[92,103,129,154],"an":[93],"obstruction":[96],"were":[97],"identified":[98],"by":[99],"confirmed":[102],"endoscopy.":[104],"study":[106,140],"supports":[107],"use":[109],"tool":[117,151],"earlier":[119],"detection":[120],"UAO,":[122],"representing":[123],"simple":[125],"effective":[127],"approach":[128],"limited":[130],"impact":[131],"on":[132],"number":[134],"referrals":[136],"generated.":[137],"Therefore,":[138],"strengthens":[141],"validation":[143],"parameter":[147],"presenting":[158]},"counts_by_year":[],"updated_date":"2026-11-04T10:54:05.112534","created_date":"2026-10-27T00:00:00"}