Accuracy and Quality of Spirometry in Primary Care Offices

RATIONALE: Spirometry is necessary for the optimal management of patients with respiratory disease. The quality of spirometry performed in the primary care setting has been inconsistent. OBJECTIVES: We aimed to evaluate spirometer accuracy, determine the clinical significance of inaccurate spirometers, and assess the quality of spirograms obtained in primary care offices. METHODS: /FVC error from an obstructed waveform to a clinical data set. Spirogram quality was determined by grading spirograms using acceptability and repeatability criteria. The relationship between the number of tests performed by a clinic and test quality was assessed. MEASUREMENTS AND MAIN RESULTS: /FVC ranging from 1.7 to 3.1%. Applying the percentage error to a clinical data set resulted in 28% of tests being recategorized from obstructed to nonobstructed. Of the spirograms reviewed, 60% were considered acceptable for clinical use. There was no association between the number of tests performed by a clinic and spirometry quality. CONCLUSIONS: Most spirometers tested were not accurate. The magnitude of the errors resulted in significant changes in the categorization of patients with obstruction. Acceptable-quality tests were produced for only 60% of patients. Our results raise concerns regarding the utility of spirometry obtained in primary care offices without greater attention to quality assurance and training.