title: Effectiveness of Spirometry Fundamentals™ for increasing  the proper use of spirometry in patients with asthma and  COPD.
abstract: OBJECTIVE
  To examine whether exposure to the Spirometry Fundamentals™ CD-ROM results in improved quality of spirometry testing in  primary care.
  
  
  METHODS
  Spirometry tests performed in 20 intervention and 19 control practices were analysed using American Thoracic Society grades  A and B for 'passing' and grades C, D and F for 'failing'. Intervention effects on spirometry quality were assessed using random effects  multivariate logistic regression.
  
  
  RESULTS
  Adjusted analyses revealed no intervention effect. The likelihood of passing tests was higher in paediatrics-only practices (adjusted  odds ratio (AOR) 2.60, 95% confidence interval (CI) 1.32 to 5.12; p=0.01). Hospital or university-based clinics had a lower performance  than private or community-based practices in unadjusted analysis (7% vs. 22% passing tests; p=0.05). However, this relationship was not  significant in adjusted analyses.
  
  
  CONCLUSIONS
  Spirometry Fundamentals™ is insufficient to improve the quality of spirometry in primary care, suggesting the need for  more comprehensive multifaceted training resources.
authors.affiliation: Center for Child Health, Behavior and Development, Seattle Children's Hospital Research Institute, Seattle, Washington 98101, USA. brookelatzke@gmail.com
authors.forename: Brooke
authors.initials: B
authors.lastname: Latzke-Davis
authors.forename: James
authors.initials: J
authors.lastname: Stout
authors.forename: Karen
authors.initials: K
authors.lastname: Smith
authors.forename: Cam
authors.initials: C
authors.lastname: Solomon
authors.forename: Michelle
authors.initials: M
authors.lastname: Garrison
authors.forename: Rita
authors.initials: R
authors.lastname: Mangione-Smith
mesh_terms: D001249:Asthma / Q000175:diagnosis*; D016251:CD-ROM; D003194:Computer-Assisted Instruction / Q000379:methods*; D004506:Education, Nursing / Q000379:methods; D004521:Educational Measurement; D005260:Female; D058006:General Practice / Q000193:education*; D006801:Humans; D016015:Logistic Models; D008297:Male; D009726:Nurses; D010820:Physicians; D011320:Primary Health Care; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis*; D013147:Spirometry / Q000592:standards