RT Journal Article SR Electronic T1 Quality of routine spirometry tests in Dutch general practices JF British Journal of General Practice JO Br J Gen Pract FD British Journal of General Practice SP e376 OP e382 DO 10.3399/bjgp09X473088 VO 59 IS 569 A1 Tjard RJ Schermer A1 Alan J Crockett A1 Patrick JP Poels A1 Jacob J van Dijke A1 Reinier P Akkermans A1 Hans F Vlek A1 Willem R Pieters YR 2009 UL http://bjgp.org/content/59/569/e376.abstract AB Background Spirometry is an indispensable tool for diagnosis and monitoring of chronic airways disease in primary care.Aim To establish the quality of routine spirometry tests in general practice, and explore associations between test quality and patient characteristics.Design of study Analysis of routine spirometry test records.Setting Fifteen general practices which had a working agreement with a local hospital pulmonary function laboratory for spirometry assessment regarding test quality and interpretation.Method Spirometry tests were judged by a pulmonary function technician and a chest physician. Proportions of test adequacy were analysed using markers for manoeuvre acceptability and test reproducibility derived from the 1994 American Thoracic Society spirometry guideline. Associations between quality markers and age, sex, and severity of obstruction were examined using logistic regression.Results Practices performed a mean of four (standard deviation = 2) spirometry tests per week; 1271 tests from 1091 adult patients were analysed; 96.4% (95% confidence interval [CI] = 95.6 to 97.2) of all tests consisted of ≥3 blows. With 60.6% of tests, forced expiratory time was the marker with the lowest acceptability rate. An overall 38.8% (95% CI = 36.0 to 41.6) of the tests met the acceptability as well as reproducibility criteria. Age, sex, and severity of obstruction were associated with test quality markers.Conclusion The quality of routine spirometry tests was better than in previous reports from primary care research settings, but there is still substantial room for improvement. Sufficient duration of forced expiratory time is the quality marker with the highest rate of inadequacy. Primary care professionals should be aware of patient characteristics that may diminish the quality of their spirometry tests. Further research is needed to establish to what extent spirometry tests that are inadequate, according to stringent international expert criteria, result in incorrect clinical interpretations in general practice.