Training Intensity Needed for Volume Linearity and Syringe D_LCO Check Quality Control

Area of Science:

• Pulmonary Medicine
• Medical Diagnostics
• Quality Control

Background:

• Accurate pulmonary function testing relies on precise equipment calibration.
• Technologists must ensure the accuracy and precision of pulmonary function equipment before patient testing.
• Quality control (QC) failures in spirometry and diffusing capacity testing impact patient care.

Purpose of the Study:

• Identify failure sources and unacceptable submission rates for spirometry volume linearity and syringe diffusing capacity of the lung for carbon monoxide (D_LCO) QC.
• Explore the impact of time between training and first QC submission on overall unacceptable submission rates.

Main Methods:

• Cross-sectional global study of 114 laboratories from October 2014 to May 2018.
• Analysis of 5,083 volume linearity and 4,992 syringe D_LCO check QC submissions.
• Descriptive statistics and Spearman's rho correlation to assess failure rates and training timelines.

Main Results:

• Unacceptable submission rates were 10% for volume linearity and 6.2% for syringe D_LCO.
• Volume linearity failures were equally split between procedural and equipment issues (5.8% vs. 6.2%).
• Syringe D_LCO failures were predominantly equipment-related (5.9% vs. 0.78%).
• Early QC failures post-training correlated with higher overall unacceptable rates for both tests (r = -0.41 and r = -0.38).

Conclusions:

• A single QC training session is insufficient for technologists.
• Clearer guidelines and expert follow-up are crucial for interpreting QC results and resolving equipment issues.
• Ongoing support is necessary to maintain in-control testing systems and ensure accurate pulmonary function diagnostics.