[Evaluation of the quality of spirometries by a scoring system].
BACKGROUND
The measurement of quality will gain in importance in the future. Suitable instruments for the measurement of the quality of lung function tests have not yet been developed. In order to evaluate the quality of lung function measurements, a score is introduced, based on current guideline recommendations for lung function test.


METHODS
Records of spirometries were selected at random and evaluated retrospectively. The evaluation criteria were deduced from guideline recommendations. The evaluation criteria were used to calculate a score in order to compare the quality of single records. The individual time course of lung function parameters in a group of former uranium ore miners was used to validate the score.


RESULTS
417 spirometry records from 93 physicians of different specialisation were evaluated. From 111 documented calibrations only 10 were accomplished on the same day on which the measurement was made. 147 lung function curves were classified as "good". Only in 25 records the execution of three or more measuring manoeuvres had been documented. The mean score over all physicians was 0.58, which corresponds to a middle quality level.


CONCLUSIONS
The study generates and validates for the first time a score with which the quality of spirometries can be evaluated. The scoring system retrospectively analyses lung function records and it can therefore be used in the framework of quality management. The application of the score showed an inconsistent application of guideline recommendations. In agreement with studies from other countries a lack of quality was also found in Germany.
Hagemeyer
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Hauptverband der gewerblichen Berufsgenossenschaften, Sankt Augustin. olaf.hagemeyer@hvbg.de
Koppisch
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Otten
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D006801:Humans; D011786:Quality Control; D015203:Reproducibility of Results; D012129:Respiratory Function Tests; D013147:Spirometry / Q000295:instrumentation / Q000379:methods*