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Because both the recommended American Thoracic Society standards and the proposed Association for the Advancement of Medical Instrumentation standards are based on performance requirements, the most reasonable test signals are those that represent actual patients. To test and qualify spirometers for compliance with a standard, a set of 24 standard waveforms have been selected from a larger set of FVC maneuvers performed by patients who have a diversity of abnormalities and demonstrate a range of test results. Common spirometric parameters are known for each waveform; therefore, the adherence to performance requirements can be readily verified. These standard waveforms are stored on various digital mediums and can be used to drive a controlled mechanical syringe for testing actual hardware and software, or they can be put into a system in digital format to test only the software.
Hankinson et al. (Sun,) studied this question.