Quality of Spirometry tests performed by 9893 adults in 14 countries: The BOLD Study

• Published in: Respiratory medicine Vol. 105; no. 10; pp. 1507 - 1515
• Main Authors: Enright, P, Vollmer, W.M, Lamprecht, B, Jensen, R, Jithoo, A, Tan, W, Studnicka, M, Burney, P, Gillespie, S, Buist, A.S
• Format: Journal Article
• Language: English
• Published: Kidlington Elsevier Ltd 01.10.2011; Elsevier; Elsevier Limited
• Subjects: Adult; Aged; Airway management; Biological and medical sciences; Chronic obstructive pulmonary disease, asthma; COPD; Female; Forced Expiratory Flow Rates; Humans; Logistic Models; Male; Medical sciences; Middle Aged; Peak Expiratory Flow Rate; Pharmaceutical industry; Pneumology; Pulmonary Disease, Chronic Obstructive - physiopathology; Pulmonary/Respiratory; Quality Assurance, Health Care - standards; Quality Control; Spirometry; Spirometry - standards; Studies; Surveys and Questionnaires; Spirometry; Quality control; COPD; Human; Lung disease; Respiratory disease; Countries; Exploration; Chronic; Lung function; Quality; Bronchus disease; Adult; Chronic obstructive pulmonary disease; Obstructive pulmonary disease; Pneumology
• ISSN: 0954-6111; 1532-3064
• DOI: 10.1016/j.rmed.2011.04.008

Summary Objective to determine the ability of participants in the Burden of Obstructive Lung Disease (BOLD) study to meet quality goals for spirometry test session quality and to assess factors contributing to good quality. Methods Following 2 days of centralized training, spirometry was performed pre- and post-bronchodilator (BD) at 14 international sites, in random population-based samples of persons aged ≥40 years, following a standardized protocol. The quality of each test session was evaluated by the spirometer software and an expert reading center. Descriptive statistics were calculated for key maneuver acceptability variables. A logistic regression model identified the predictors of acceptable quality test sessions. Results About 96% of test sessions met our quality goals for a low back-extrapolated volume (BEV), time to peak flow (PEFT), and end-of-test volume (EOTV). The mean forced expiratory time (FET) was 10.4 s. Ninety percent of the maneuvers with the highest FVC had a forced expiratory time (FET) > 6.8 s. About 90% of test sessions had FEV1 and FVC which were repeatable within 150 mL. Test quality was slightly better for post-BD test sessions when compared to pre-BD. Independent predictors of adequate test quality included female sex, younger age, higher education, lack of dyspnea, higher pre-BD FEV1 , less BD responsiveness, and study site. Conclusions Quality goals for spirometry tests were met about 90% of the time in these population-based samples of adults from several countries.