Spirometry quality in a secondary care outpatient setting in comparison to physiologists in a lung function lab

Introduction: A clinical audit assessed the quality of spirometry performed in our respiratory medicine clinic by physicians and nurses. Comparison of results obtained in the clinic(CL) and lung function laboratory(LF) was undertaken. Aims: To investigate CL spirometry adherence to the ERS/ATS acceptability criteria and, if the acceptability criteria were not being met, whether this caused a significant difference to patients9 results. Methods: Data was collected retrospectively. The number of manoeuvres, values and type & number of errors per test were recorded. To compare the results between CL and LF the FEV1, FVC, FER, PEF from the best manoeuvre in each test from 40 individuals, who had had tests in both settings, were compared and a T-test used to statistically analyse any significant differences. Results: Of 1008 tests, 778 (77.18%) performed Conclusions: The data demonstrated a high proportion of spirometry performed in CL did not meet standards outlined by the ERS/ATS guidelines; specifically, insufficient number of manoeuvres per test and a high number of errors. Significant differences in some parameters could result in mis-diagnosis or differing severity classification. Further analysis is needed to see whether there is a correlation between the number of manoeuvres performed and the impact on values gained.