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Analysis of variability in interpretation of spirometric tests
S A Quadrelli1, A J Roncoroni, G Porcel
1Instituto de Investigaciones Médicas Alfredo Lanari, Universidad de Buenos Aires, Argentina.
Respiration; International Review of Thoracic Diseases
|January 1, 1996
Summary
Pulmonologists often disagree on interpreting spirometry results for airway obstruction and bronchodilator response. Inconsistent definitions in clinical trials complicate the comparison of study findings.
Area of Science:
- Pulmonology
- Respiratory Medicine
- Clinical Diagnostics
Background:
- Spirometry interpretation and definitions of airway obstruction and bronchodilator response lack standardization.
- Variability in interpretation can impact clinical trial outcomes and patient diagnosis.
Purpose of the Study:
- To quantify disagreement in spirometry interpretation among pulmonologists.
- To analyze the variability in definitions of airway obstruction and bronchodilator response in published literature.
Main Methods:
- Two surveys involving pulmonologists assessing spirometry for obstructive/restrictive defects and bronchodilator response.
- Review of articles on asthma and COPD for criteria defining obstruction and bronchodilator response.
Main Results:
- Maximum agreement for restrictive defects was 76.1%, and for obstructive defects was 63.6%.
- Disagreement on bronchodilator response reached 24% (53.3% maximal disagreement).
- Eleven criteria for obstruction and five for bronchodilator response were identified in literature.
Conclusions:
- Significant disagreement exists in the interpretation of spirometry.
- Lack of uniform definitions for obstruction and reversibility in clinical trials hinders result extrapolation.
- Care is needed when comparing findings across studies due to sample composition differences.