Interpretation of Spirometry: Beyond the Numbers

Previously known as “Spirometry for Physicians”, this one day course is ideal for all health professionals who desire a comprehensive course designed specifically to address practical interpretation of spirometry tests. Interpretative strategies will be consistent with standards published by the American Thoracic Society (ATS) and European Respiratory Society (ERS) and will include a review of current standards. Practice problems will be used to help the student recognize acceptable from unacceptable trials and when unacceptable maneuvers still have usable information. Examples of poorly administered and improperly performed tests will be used to help recognize poor subject effort, unacceptable maneuvers, limitations of equipment, and other factors that alter the interpretation algorithm. Students will also learn how to recognize the magnitude and direction of error introduced when less than ideal results are obtained. Guidelines regarding the use and selection of predicted values, and race adjustments will be presented.

A variety of methods will be presented to identify potentially significant changes in lung function. This information is very helpful in regards to identifying persons with true lung disease versus variability in the test. This course is a "must" for persons who need comprehensive training to properly interpret spirometry tests. At the conclusion of this course, students will be capable of recognizing acceptable spirometry maneuvers and will learn how to interpret test results while decreasing the false positive and false negative rate of obstructive and restrictive lung disease.

Objectives:
  • Recognize important components of spirometry standards that impact interpretation of results.
  • Interpret spirometry graphs as to the type of pattern.
  • Recognize conditions that affect spirometry results.
  • Identify errors in testing equipment or procedures that may affect results.
  • Clarify the significance of current guidelines for spirometry testing.
  • Recognize potentially significant change in spirometry testing.
Times
Topic
8:30 – 11:30
Review of Common Measurement and Standards:
    FVC, End of Test Criteria, Peak Flow, FEV1, FEV1/FVC, etc.
    Recognizing & Impact of Excessive Hesitating Starts (EV > 5%)
    ATS-ERS Acceptability & Repeatability Criteria
    Magnitude & Direction of Poor Quality on Interpretation
11:30 - 12 noon
Predicted and Percent of Predicted Values:
    Definition, Factors used to Determine Predicted Values,
    Race Adjustments, Comparison of Predicted Values,
Lower Limits of Normal:
    Rules of Thumb Approaches, Statistical Lower Limits of Normal
    5th Percentiles, 95% Confidence Limits, Z-scores
12:00 – 1:00
Lunch Break
1:00 - 5:00
Interpretation Issues
Obstructive, Restrictive, & Mixed Patterns
Pattern identification on Volume-Time and Flow-Volume Tracings
How Testing Technique Influences Spirometry Patterns/Interpretation
Inadequate Plateau Issues
Interpretation of FEV6, FEV1/FEV6
Evaluating Longitudinal Change in Lung Function