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Published ahead of print on November 6, 2003, doi:10.1164/rccm.200204-347OC

Am. J. Respir. Crit. Care Med., Volume 169, Number 2, January 2004, 235-238

A more recent version of this article appeared on January 15, 2004
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Submitted on April 19, 2002
Accepted on November 5, 2003

Repeatability of Spirometry in 18,000 Adult Patients

Paul L Enright1*, Kenneth C Beck2, and Duane L Sherrill1

1 Public Health, The University of Arizona, Tucson, AZ, USA, 2 Radiology, The University of Iowa Hospitals and Clinics, Iowa City, IA, USA

* To whom correspondence should be addressed. E-mail: lungguy{at}aol.com.

The objective of this study was to determine the limits for repeatability of FEV1, FVC, and PEF during spirometry test sessions in adult outpatients. A retrospective chart review of 18,000 consecutive patients, ages 20-90, referred to a large outpatient pulmonary function laboratory for testing was performed. Measurements included the differences between the highest and second-highest forced vital capacity (dFVC), forced expired volume in one second (dFEV1), and peak expiratory flow (dPEF), from pre-bronchodilator spirometry, and anthropometric factors. Ninety percent of the patients were able to reproduce FEV1 within 120 mL (6.1%), FVC within 150 mL (5.3%), and PEF within 0.80 L/sec (12%). Patient characteristics, such as gender, age, height, smoking status, and FEV1 (%predicted), had very little effect on repeatability, explaining only 2-4% of the variation in repeatability (expressed in mL). We conclude that the ability of patients to meet or exceed spirometry repeatability goals does not depend on patient characteristics when testing is performed by experienced personnel. The current ATS repeatability goal of 200mL for FEV1 and FVC may be too lenient.
Key words: Spirometry, quality control




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