Abstract
Background:
At this time, many general practices in the Netherlands have their own spirometer. However, there are indications in the literature that spirometry performed in the general practice setting may be inaccurate.
Aims:
To compare FEV1 and FVC values obtained in general practice to a ‘gold standard', i.e. the same parameters obtained in a pulmonary function laboratory by an experienced lung function technician.
Methods:
General practitioners and practice assistants from 61 Dutch general practices were trained to perform spirometry. Subsequently, these practices recruited patients with COPD for study participation. For each patient, pre- and post-bronchodilator (BD) FEV1 and FVC values were first assessed in a pulmonary function laboratory and within a few days again in the patients' own general practice. The same type of spirometer (Microloop II, MicroMedical Ltd.) and spirometry software (Spirare, Diagnostica Ltd.) was used in all practices as well as in the pulmonary function laboratory.
Results:
Pairs of spirometric tests were available for 299 patients. (197 males, mean age 59.2 [SD 9.6], mean FEV1 % predicted 62.8 [SD 17.6]). Pre-BD FEV1 was on average 79 ml (95% CI 55, 103) and FVC 99 ml (95% CI 54, 143) higher for the general practice measurements. For post-BD measurements, FEV1 was 61 ml (95% CI 39, 84) and FVC 49 ml (95% CI 3, 95) higher, also in favour of the general practice measurements.
Conclusion:
Relevant spirometric values (FEV1, FVC) obtained in general practice appear to be equivalent to values obtained in a pulmonary function laboratory. Further analyses of our data are required to eliminate possible alternative explanations for this rather unexpected finding.
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Schermer, T., Chavannes, N., Jacobs, A. et al. Accuracy of spirometry in general practice. results of an evaluation study in patients with chronic obstructive pulmonary disease (COPD). Prim Care Respir J 11, 96 (2002). https://doi.org/10.1038/pcrj.2002.95
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DOI: https://doi.org/10.1038/pcrj.2002.95