Validity of spirometry performed online

Area of Science:

• Pulmonary Medicine
• Medical Technology

Background:

• Spirometry is crucial for diagnosing and managing respiratory diseases.
• Current spirometry use and quality are suboptimal in primary care due to technical challenges.

Purpose of the Study:

• To compare the efficacy and quality of online spirometry performed remotely by technicians versus conventional spirometry.
• To assess the feasibility of remote spirometry for primary care settings.

Main Methods:

• A controlled, randomized crossover study involving 261 patients from primary care referred for pulmonary consultation.
• Patients were randomized to undergo either conventional spirometry or online spirometry, where a remote technician guided the procedure via teleconference.
• Agreement was assessed using Bland-Altman plots, and intra- and interobserver reliability was evaluated using the intraclass correlation coefficient.

Main Results:

• No clinically significant differences were observed in spirometric values between online and conventional methods.
• Per-protocol analysis showed better agreement and identification of abnormal spirometry in off-range patients compared to intention-to-treat analysis.
• Conventional spirometry showed a slightly higher percentage of patients meeting quality criteria, with a minimal difference of 5.9%.

Conclusions:

• Online spirometry conducted from a hospital's pulmonary function laboratory is an adequate alternative to conventional spirometry for primary care.
• This remote approach can help overcome technical difficulties and improve the quality of spirometry in primary care settings.