Spirometry performance and quality criteria AS OF ATS/ERS2019 in an epidemiological study

Aim. To test the performance and assess the feasibility of spirometric quality criteria of ATS/ERS2019 protocol in an epidemiological study.

Materials and methods. Spirometry was completed in 989 adults (18 years old and older, median age 42 (interquartile range (IQR) 25;55) years), residents of Shymkent selected from the general population after training. Spirometry quality was assessed with a range of criteria, including the difference in forced expiratory volume in 1 second (FEV₁) and forced vital capacity (FVC) between attempts, whereas the predictors of criteria attainment were tested in adjusted regression models.

Results and discussion. Total number of attempts varied from 3 to 23 (median 4, IQR 3;6) and it was independently associated with age, FEV₁%, smoking status and educational level. ΔFEV₁ median equaled 0.05 l (IQR 0.03;0.09), whereas ΔFVC median was 0.06 (IQR 0.03;0.10). Back extrapolation volume median was 0.07 (IQR 0.05;0.11). End-expiratory flow (EEF) median was 0.16 (IQR 0.09;0.33) l, and was independently associated with age, FEV₁, FVC and their ratio, as well as diagnosed COPD. The target EEF value of 0.025 l/s could be attained in only 13 subjects (1%) out of 989.

Conclusions. Overall, high standard of spirometry could be attained with the majority of indicators after the relevant training; however, keeping the expiration till the target end-expiratory flow of 25 ml/s is the greatest challenge and hard to achieve.

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