RT Journal Article
SR Electronic
T1 Validity of spirometry performed on-line
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP erj00115-2010
DO 10.1183/09031936.00011510
A1 J.F. Masa
A1 M.T. González
A1 R. Pereira
A1 M. Mota
A1 J.A. Riesco
A1 J. Corral
A1 J. Zamorano
A1 M. Rubio
A1 J. Teran
A1 R. Farré
YR 2010
UL http://erj.ersjournals.com/content/early/2010/07/22/09031936.00011510.abstract
AB Spirometry is essential for the diagnosis and management of common respiratory diseases. However, its use and quality is low in primary care. An important reason is the technical difficulty in performing conventional spirometry. If high quality spirometry could be performed on-line, from the pulmonary function laboratory in hospitals, most of the technical problems could be solved.To compare spirometries performed on line by remote technicians with conventional spirometry.This was a controlled, randomized crossover study. Two hundred and sixty one patients referred from primary care centres for pulmonary consultation were the target population. They were randomized to begin with either conventional or on-line spirometries. The technician, located remotely, controlled the spirometer computer. Using a teleconference link, the technician guided the patient through the spirometry. The comparison between conventional and on line spirometries was performed on an “intention to treat” and “per protocol” basis for spirometric values and quality criteria. Agreement between the two spirometric methods was assessed with a Bland and Altman plot. A subpopulation of off-range patients was also characterized. Finally, intra- and inter-observer agreement was evaluated using the intraclass correlation coefficient.No clinically significant differences were seen between the on-line and conventional spirometric values in both the intention to treat and per protocol analyses. The agreement in Bland and Altman analysis was worse for intention to treat than for the per protocol analysis. The latter had a lower percentage of off-range patients, and high agreement to determine abnormal spirometry in off-range group. Conventional spirometry had a higher percentage of patients with spirometric quality criteria although the quality criteria difference was only 5.9%, when both procedures were the first to start. Very good agreement was found between intra and inter-observer reliability.Spirometry performed on-line from a hospital can be an adequate alternative to conventional spirometry for primary care centres.