Quality control of spirometry in the elderly - The SARA study

We evaluated the outcome of the spirometry quality control program of the S A.R.A. multicenter project, the aim of which is the multidimensional assess ment of asthma and COPD in the elderly (greater than or equal to 65 yr). Th e factors determining this quality were also evaluated. The program was bas ed on standardized procedures (ATS recommendations), performed by specifica lly trained and certified personnel; a fully-computerized spirometer with c ustomized software was used for spirometry. A reference center made monthly controls. Overall, 638 Eases and 984 controls were examined. Spirometric m easurements were obtained in 607 cases and 912 controls; 508 and 747 tests with at least three acceptable curves were obtained in cases and in control s, respectively (NS). The percentage of reproducible tests ranged between 9 5.8% for FEV1 in controls and 87.6% for FVC in cases. The average reproduci bility for FEV1 was 61.6 ml in cases and 58.3 ml in controls (NS). Cognitiv e impairment, shorter 6-min walk distance, and lower educational level were found to be independent risk factors for a poorer acceptability rate (logi stic regression analysis). Male sex and age were risk factors for a poorer reproducibility of FEV1. Reproducibility tended to Improve with time (p < 0 .001). Although spirometry becomes increasingly difficult in aging patients , a rigorous quality control program can ensure that reliable data are obta ined in the majority of patients.