We devised a new questionnaire about the user friendliness of office spirometers. The results of this small and informative survey suggest large similarities among the majority of the spirometers. Almost all of them have an interface with a personal computer, can be connected to a printer, and have correct help functions. An important issue is the automated quality assessment. Most of the devices check the reproducibility and the acceptability of the spirometric maneuvers. Many spirometers display immediately messages about the quality of the “blow.” The software offers mostly a large choice of reference tables and provides an automated interpretation. According to some authors,” this feature is not without danger of misinterpretation for uninformed users. Large differences were encountered for the facility to use during home visits. Some devices are readily excluded by their large size. Some spirometers display a flow-volume curve on a small screen on the device itself. The need for calibration of the spirometers is a controversial aspect. read more
It is not realistic to expect a GP to handle on a daily basis a 3-L calibration syringe and perform a calibration check. Most manufacturers claim that their device does not need any further calibration or even calibration checks. In fact, the majority of the office spirometers cannot be calibrated by the user, and calibration can only be checked. The new ATS/ERS statement on standardization of spirometry, published after the first submission of this study, requires that flow spirometer calibration be checked daily using different speeds of injection to verify that the spirometers measure accurately across a range of flows. More studies are needed to verify the stability of each device over months to years of use.
Another important property is the integration of the spirometric data into the patient data files. The management of the medical data is “core business” for the GP. However, technical specifications may vary largely from one country to the other. In the Belgian situation, the I-Med standard in XML (extensible markup language) format is becoming increasingly important as an interface between electronic medical data files and external information. Extensible markup language format is designed especially for Web documents and to enable the transmission, validation, and interpretation of data between applications and between organizations. There is plenty of room for improvement in international standardization in this domain, as it was proposed in the recent ATS/ERS guidelines for standardization of spirometry.