The basic part of any pulmonary assessment is simple spirometry comprising the measurement of forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV₁). Historically these measurements represent refinements made by Tiffeneau in 1947 of the original concept of vital capacity (VC), introduced by John Hutchinson >100 years earlier.1 Impressively, Hutchinson not only invented this measurement and described its dependence on age, height and weight, but he also performed the first epidemiological study of >2000 individuals and observed a strong relationship between the measured value and survival. Thus, the actual reason for calling the amount of exhaled air from the fully inflated lungs the ‘vital capacity’ was the observation made by its inventor indicating that this measurement was strongly related to survival.1

Later on, during the first half of the 20th century, although some investigators from time to time reported the usefulness of VC for prediction of health-related outcomes, it seems that the predictive power of VC was to a large degree forgotten.2 Ironically, in the mid-1970s a series of scientific papers initiated a renewed interest in these measurement in the general population. These studies did not come from respiratory physicians but from cardiologists, and were based on The Framingham Study, the first major cardiovascular epidemiological study.3 4 The measurement of slow VC was actually included in the Framingham examination panel already in 1956—that is, 8 years after the beginning of the first investigation, whereas spirometry with registration of FEV₁ and FVC was first measured in 1971. Thus, the Framingham investigators rediscovered the astonishing power of lung function measurements, in particular FVC, as predictors of both survival and …