Improvement in Lung Function Measurements Using a Flow Spirometer that Emphasizes Computer Assessment of Test Quality

Abstract

We compared retrospective measurements of lung function from 101 steel workers using a commercially available spirometer to prospective lung function measurements performed, on average, 1.3 years later, with a newly developed spirometer. This spirometer was designed and developed to incorporate technology that provides immediate feedback on the quantitative and qualitative aspects of each forced expiratory effort. Of the 101 workers, 82 who had spirometry performed with each spirometer had at least two acceptable curves, and 51 workers tested with each spirometer had curves that met all American Thoracic Society (ATS) criteria for spirometry. No group showed the anticipated decline in forced expiratory volume in 1 second (FEV1) over time. The results showed an increased number of curves meeting ATS acceptability and reproducibility criteria, and a statistically significant increase in the FVC in all groups, and an increase in the FEV1 in the group encompassing all workers. Use of technology that strengthens the interaction between the spirometry technician, the data available to the technician on the computer, and the participant appears to represent true underlying lung function more accurately. Such an approach to the collection of lung function data should be considered by those evaluating spirometers for implementation in the workplace or pulmonary function laboratory as well as by those planning future spirometer development.

Feedback information from flow volume curves to the practice

“…Most modern spirometers display real-time F/V or volume-time curves during forced breathing manoeuvres. However, apart from one single observational study 3 we could find no evidence for the assumption that providing technicians with feedback information from F/V curves contributes to the overall quality of forced breathing manoeuvres including spirometry testing.…”

FEV6 as a surrogate for FVC in detecting airways obstruction and restriction in the workplace

“…Spirometry results from four recently performed investigations were used to evaluate the possibility that use of FEV6 would also be acceptable in workplace investigations. Products, Madison, WI, USA) with software that checks for unacceptable manoeuvres [7]. Four highly experienced NIOSH technicians followed American Thoracic Society (ATS) spirometry recommendations [1].…”

Spirometry to detect and manage chronic obstructive pulmonary disease and asthma in the primary care setting

“…The primary function of the computer is to measure the spirometry results for each manoeuvre, calculate predicted values, and format a printed report. Office spirometry software should also help the spirometry technologist to obtain better quality test sessions [13,14]. Each manoeuvre should be checked for acceptability and appropriate error messages displayed (table 1).…”