Aksu Kurtuluş, Fırıncıoğluları Ali, Aksu Funda
Department of Chest Diseases, Health Sciences University, Atatürk Chest Diseases and Chest Surgery Training and Research Hospital, Ankara, Turkey.
Tuberk Toraks. 2020 Jul;68(2):112-117. doi: 10.5578/tt.69716.
First step is to evaluate the quality of the test in interpreting spirometries. International societies have defined the acceptability criteria for spirometric tests. With this study, it was aimed to evaluate spirometric tests in terms of compliance with international acceptability criteria and to determine error types.
Spirometric manoeuvres held at a tertiary chest diseases hospital were evaluated as to whether the acceptability criteria of "American Thoracic Society/European Respiratory Society (ATS/ERS)" guideline were maintained or not. Errors determined were classified as unexplosive start of expiration, submaximal effort, cough, closure of glottis, missing closure of the loop ring and early termination of expiration.
Among tests evaluated (n= 510), 276 (54.1%) belonged to female and 234 (45.9%) to male subjects. Average age of subjects was 56.1 ± 15.0 years. It was noted that 318 (62.4%) of the tests met acceptability criteria, whereas 192 (37.6%) did not. The most frequently noted error type is submaximal effort by 30.2% followed by missing closure of the loop, early terminaton of expiration, coughing, unexplosive start of expiration and closure of glottis. In the tests whose spirometric maneuvers did not meet the criteria, the mean age of the patients was significantly higher than in the appropriate tests. When the cases were grouped according to their age, it was observed that the rate of conformity of spirometric examinations decreased significantly as the age range increased.
Within this study it is the first time in our country that evaluation of spirometric studies has been made to see the rate of conformity with international standarts. Although it is thought that spirometric examinations are not technically appropriate in clinical practice throughout our country, there is no data in the literature. Although the center where the study is conducted is a tertiary chest diseases hospital, the data obtained reveal that in spirometric evaluations, a substantially non-standard examination was performed.
第一步是评估测试在解读肺量计检查结果方面的质量。国际协会已经定义了肺量计测试的可接受标准。本研究旨在根据国际可接受标准评估肺量计测试，并确定错误类型。
对一家三级胸科疾病医院进行的肺量计操作进行评估，以确定是否符合“美国胸科学会/欧洲呼吸学会（ATS/ERS）”指南的可接受标准。确定的错误分类为呼气起始无爆发力、用力不足、咳嗽、声门关闭、环圈未闭合以及呼气提前终止。
在评估的测试中（n = 510），276例（54.1%）属于女性受试者，234例（45.9%）属于男性受试者。受试者的平均年龄为56.1±15.0岁。注意到318例（62.4%）测试符合可接受标准，而192例（37.6%）不符合。最常出现的错误类型是用力不足，占30.2%，其次是环圈未闭合、呼气提前终止、咳嗽、呼气起始无爆发力和声门关闭。在肺量计操作不符合标准的测试中，患者的平均年龄显著高于符合标准的测试。当根据年龄对病例进行分组时，观察到随着年龄范围的增加，肺量计检查的符合率显著下降。
在本研究中，这是我国首次对肺量计研究进行评估，以查看与国际标准的符合率。尽管认为在我国临床实践中肺量计检查在技术上不合适，但文献中没有相关数据。尽管进行研究的中心是一家三级胸科疾病医院，但获得的数据显示，在肺量计评估中，进行的检查基本上不标准。
