Abstract
We report the characteristics of a centralized spirometry quality-control program developed for a population-based survey of the prevalence of chronic obstructive pulmonary disease in 5 cities: São Paulo, Brazil; México City, México; Montevideo, Uruguay; Santiago, Chile; and Caracas, Venezuela (the Latin American Project for the Investigation of Obstructive Lung Diseases [PLATINO]).
METHODS: We developed and used a 3-level quality-control system. Level 1: The spirometer used in the survey (EasyOne), gives quality-control messages to the user/clinician. All the spirometry technicians were trained by the same team, with the aim of meeting what became the 2005 spirometry quality criteria of the American Thoracic Society/European Respiratory Society (ATS/ERS). Level 2: In each of the 5 cities a local supervisor identified poor-quality spirometries that needed to be repeated. Level 3: Once a week during the survey, all spirometry results were sent via e-mail to the study's quality-control center in México City for review and feedback.
RESULTS: In the overall totals at the end of the study, 94% of the 5,315 subjects had spirometries that met the 1994 ATS quality criteria, and 89% met the 2005 ATS/ERS criteria. In their overall totals at the end of the study, 90% of the 64 spirometry technicians were successful in getting 86% of their subjects to meet the 1994 ATS criteria, and got 75% of their subjects to meet the 2005 ATS/ERS criteria. In the first 10 subjects they tested, 90% of the 64 spirometry technicians were successful in getting 70% of their subjects to meet the 1994 ATS criteria, and got 60% of their subjects to meet the 2005 ATS/ERS criteria.
CONCLUSIONS: Standardization of equipment, training, and supervision of spirometry is essential in a multinational spirometry survey. Centralized quality control can be done via e-mail with good reliability and low cost.
- chronic obstructive pulmonary disease
- COPD
- spirometry
- quality control
- pulmonary function tests
- latin america
Footnotes
- Correspondence: Rogelio Pérez-Padilla MD, Instituto Nacional de Enfermedades Respiratorias, Tlalpan 4502, Distrito Federal, Ciudad de México, México 14080. E-mail perezpad{at}servidor.unam.mx.
↵* The PLATINO Group also includes Alexander Corcho-Berdugo MD and Francisco-Franco-Marina MD, Instituto Nacional de Enfermedades Respiratorias, Mèxico City, Mèxico; Pedro Curi Hallal MD, Universidade Federal de Pelotas, Pelotas, Brazil; and Carmen Lisboa, Pontificia Universidad Católica de Chile, Santiago, Chile. The coordinators of the spirometry teams were Fernanda W Rosa, Aquiles Camelier MD, Oliver Nascimento, Elisa Sánchez-Gallèn, Abigail Guzmán, Marcela Araya, and Dolores Moreno MD. Principal investigators were Adriana Muiño MD and María Victorina López MD, Universidad de la Repúlica, Montevideo, Uruguay; María Montes de Oca MD and Carlos Tálamo MD, Universidad Central de Venezuela, Caracas, Venezuela; Jose Roberto B Jardim, Universidade Federal de São Paulo, São Paulo, Brazil; Gonzalo Valdivia MD and Julio Pertuzé, Pontificia Universidad Católica de Chile, Santiago, Chile, and Rogelio Pérez-Padilla.
This study was supported by a grant from Boehringer-Ingelheim; the grant was partly used to purchase the spirometers. The study received no support from ndd Medical Technologies, the maker of the EasyOne spirometer used in this study. Boehringer-Ingelheim did not influence the design of the study, the analysis of the data, or the writing of the manuscript. The authors report no conflict of interest in the content of this paper.
- Copyright © 2008 by Daedalus Enterprises Inc.
