0
Original Research |

A Survey of Practices of Pulmonary Function Interpretation in Laboratories in Northeast OhioPulmonary Function Interpretation Practices

Manish R. Mohanka, MD; Kevin McCarthy, RPFT; Meng Xu, MS; James K. Stoller, MD, FCCP
Author and Funding Information

From the Cleveland Clinic Foundation, Cleveland, OH.

Correspondence to: Manish R. Mohanka, MD, Respiratory Institute, Cleveland Clinic Foundation, 9500 Euclid Ave/A90, Cleveland, OH 44195; e-mail: mohankm@ccf.org


Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestpubs.org/site/misc/reprints.xhtml).

Funding/Support: The authors have reported to CHEST that no funding was received for this study.


© 2012 American College of Chest Physicians


Chest. 2012;141(4):1040-1046. doi:10.1378/chest.11-1141
Text Size: A A A
Published online

Background:  Because many different reference equations are available for pulmonary function testing (PFT), and because different interpretive strategies could affect the interpretation of results, we assessed the variation in practice among 17 PFT laboratories.

Methods:  PFT laboratory directors/supervisors in 17 hospitals (near Cleveland, Ohio) were surveyed between September 15, 2010, and January 5, 2011. The survey assessed the features of the laboratory, including equipment used, types of tests offered, volume of testing, reference equations used, and interpretive strategies employed (eg, how normal was determined, how tests were actually read, and so forth).

Results:  Responses were received from all 17 laboratories and were verified using submitted sample PFT reports. The daily median number of tests performed and patients evaluated were 16 and six, respectively. Great variation was observed not only in the choice of reference equations for spirometry, but also in the criteria used to define airflow obstruction. Great variation was also observed in the reference equations used for lung volumes and diffusing capacity, as well as in the criteria used to define physiologic derangements such as restriction, hyperinflation, air trapping, and impaired diffusing capacity. Only three of the 17 laboratories reported and used the “lower limit of normal” to define PFT abnormality.

Conclusions:  This survey demonstrated substantial variation in PFT laboratory practices, including the choice of reference equations, the criteria used to define abnormality, and the strategies for interpreting tests. The degree of variation raises concern about the consistency of the interpretation of results among laboratories and emphasizes the value of compliance with official guidelines to drive standardization.

Figures in this Article

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
CHEST Journal Articles
PubMed Articles
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543