title: Feasibility and validation of telespirometry in general practice: The Italian "Alliance" study.
abstract: BACKGROUND
  At variance from office spirometry, telespirometry has not been tested as a tool for improving the ability of general practitioners (GPs) to manage chronic airway diseases.
  
  
  METHODS
  After adequate training, 937 Italian GPs agreed to perform telespirometry in subjects attending their clinics who had risk factors, persistent respiratory symptoms, or a previous diagnosis of asthma or COPD. Each subject performed at least three forced expiratory manoeuvres using a turbine spirometer. Traces were sent by telephone to a Telespirometry Central Office, where they were interpreted by a pulmonary specialist, according to defined criteria. The result was sent in real time to the GP to assist the management of the patient.
  
  
  RESULTS
  During 2 years, 20,757 telespirometries were performed, with a mean of 22.2+/-25.2 examinations for each GP. 70% of the tests met the criteria for good or partial co-operation, allowing spirometric abnormalities to be detected in more than 40% of the tracings. The rate of telespirometries that could not be evaluated at all was reasonably low (9.2%). For a subset of the telespirometries, a comparison between acceptability criteria for telespirometry and those recommended for laboratory (ATS) or office spirometry showed that the majority of telespirometries with good co-operation satisfied completely, or with minor deviations, the ATS and Office criteria.
  
  
  CONCLUSIONS
  Telespirometry was well accepted by Italian GPs, who obtained acceptable screening traces in a large percentage of subjects. Therefore it might be considered a useful alternative to office spirometry in improving the management of chronic airway diseases by GPs.
authors.affiliation: Respiratory Department, Genova, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Bonavia
authors.forename: G
authors.initials: G
authors.lastname: Averame
authors.forename: W
authors.initials: W
authors.lastname: Canonica
authors.forename: C
authors.initials: C
authors.lastname: Cricelli
authors.forename: V
authors.initials: V
authors.lastname: Fogliani
authors.forename: C
authors.initials: C
authors.lastname: Grassi
authors.forename: A M
authors.initials: AM
authors.lastname: Moretti
authors.forename: P
authors.initials: P
authors.lastname: Ferri
authors.forename: A
authors.initials: A
authors.lastname: Rossi
authors.forename: P L
authors.initials: PL
authors.lastname: Paggiaro
mesh_terms: D000328:Adult; D001249:Asthma / Q000175:diagnosis* / Q000628:therapy; D002983:Clinical Competence; D005194:Family Practice / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D010821:Physicians, Family; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis* / Q000628:therapy; D011785:Quality Assurance, Health Care; D012307:Risk Factors; D013147:Spirometry / Q000295:instrumentation / Q000379:methods*; D017216:Telemedicine / Q000295:instrumentation / Q000379:methods*; D016896:Treatment Outcome