What does this research mean for the field?

The FEMOS classification framework for Excessive Dynamic Airway Collapse (EDAC) should be refined to incorporate a ≥ 70% collapse threshold and additional anatomical and morphological markers to reduce diagnostic heterogeneity. Novelty: ClaimNovelty.SYNTHESIS. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

The aim is to systematically evaluate the FEMOS classification for diagnosing Excessive Dynamic Airway Collapse (EDAC).

March 8, 2026Open Access

Excessive dynamic airway collapse and the FEMOS classification: a descriptive systematic review and framework proposal

Key Points

The aim is to systematically evaluate the FEMOS classification for diagnosing Excessive Dynamic Airway Collapse (EDAC).
Conducted a descriptive systematic review following PRISMA guidelines on 16 EDAC studies published from 2005 to 2023.
Assessed methodological quality using the JBI Critical Appraisal Tools, identifying gaps in study designs.
Evaluated diagnostic thresholds and anatomical reporting of airway collapse in the included studies.
Identified moderate methodological quality primarily from case series studies with variable diagnostic thresholds.
Found predominant anatomical involvement of the distal trachea (68.8%) and main bronchi (87.5%), with common conditions being asthma and COPD.
Proposed a refinement of the FEMOS framework focusing on a ≥ 70% threshold for collapses based on objective measures.

Abstract

Abstract Introduction Excessive Dynamic Airway Collapse (EDAC) remains inconsistently diagnosed due to variable thresholds and overlapping terminology. The FEMOS (Functional status, Extent, Morphology, Origin, Severity) classification is the most comprehensive multidimensional framework for central airway collapse, yet its application in EDAC has not been systematically evaluated. Methods interpretation should therefore remain cautious.

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