Differences in spirometry interpretation algorithms: influence on decision making among primary-care physicians

NPJ Primary Care Respiratory Medicine
Xiao-Ou HeEvan Lilly

Abstract

Spirometry is recommended for the diagnosis of asthma and chronic obstructive pulmonary disease (COPD) in international guidelines and may be useful for distinguishing asthma from COPD. Numerous spirometry interpretation algorithms (SIAs) are described in the literature, but no studies highlight how different SIAs may influence the interpretation of the same spirometric data. We examined how two different SIAs may influence decision making among primary-care physicians. Data for this initiative were gathered from 113 primary-care physicians attending accredited workshops in Canada between 2011 and 2013. Physicians were asked to interpret nine spirograms presented twice in random sequence using two different SIAs and touch pad technology for anonymous data recording. We observed differences in the interpretation of spirograms using two different SIAs. When the pre-bronchodilator FEV1/FVC (forced expiratory volume in one second/forced vital capacity) ratio was >0.70, algorithm 1 led to a 'normal' interpretation (78% of physicians), whereas algorithm 2 prompted a bronchodilator challenge revealing changes in FEV1 that were consistent with asthma, an interpretation selected by 94% of physicians. When the FEV1/FVC ratio was <0.70 af...Continue Reading

References

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Citations

Mar 25, 2019·The Journal of Asthma : Official Journal of the Association for the Care of Asthma·Audrey DesjardinsLouis-Philippe Boulet

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