Objective. The aim of this study was to investigate the validity of office spirometry in primary care pediatric practices.Methods. Ten primary care pediatricians undertook a spirometry training program that was led by 2 pediatric pulmonologists from the Pediatric Department of the University of Padova. After the pediatricians' training, children with asthma or persistent cough underwent a spirometric test in the pediatrician's office and at a pulmonary function (PF) laboratory, in the same day in random order. Both spirometric tests were performed with a portable turbine flow sensor spirometer. We assessed the quality of the spirometric tests and compared a range of PF parameters obtained in the pediatricians' offices and in the PF laboratory according to the Bland and Altman method.Results. A total of 109 children (mean age: 10.4 years; range: 6–15) were included in the study. Eighty-five (78%) of the spirometric tests that were performed in the pediatricians' offices met all of the acceptability and reproducibility criteria. The 24 unacceptable test results were attributable largely to a slow start and failure to satisfy end-of-test criteria. Only the 85 acceptable spirometric tests were considered for analysis. The agreement between the spirometric tests that were performed in the pediatrician's office and in the PF laboratory was good for the key parameters (forced vital capacity, forced expiratory volume in 1 second, and forced expiratory flow between 25% and 75%). The repeatability coefficient was 0.26 L for forced expiratory volume in 1 second (83 of 85 values fall within this range), 0.30 L for forced vital capacity (81 values fall within this range), and 0.58 L/s for forced expiratory flow between 25% and 75% (82 values fall within this range). In 79% of cases, the primary care pediatricians interpreted the spirometric tests correctly.Conclusions. It seems justifiable to perform spirometry in pediatric primary care, but an integrated approach involving both the primary care pediatrician and certified pediatric respiratory medicine centers is recommended because effective training and quality assurance are vital prerequisites for successful spirometry.
展开▼
机译：目的。这项研究的目的是调查办公室肺活量测定法在初级保健儿科实践中的有效性。十名初级保健儿科医生进行了一项肺活量测定培训计划，该计划由帕多瓦大学儿科的两名儿科肺科医生领导。接受儿科医生培训后，患有哮喘或持续咳嗽的儿童在当天随机在儿科医生办公室和肺功能（PF）实验室进行了肺活量检查。两种肺活量测试均使用便携式涡轮流量传感器肺活量计进行。我们评估了肺活量测试的质量，并根据Bland和Altman方法比较了在儿科医生办公室和PF实验室中获得的一系列PF参数。该研究共纳入109名儿童（平均年龄：10.4岁;范围：6-15）。儿科医生办公室进行的肺活量测试中有八十五（78％）个符合所有可接受性和可重复性标准。这24个不可接受的测试结果主要归因于启动缓慢和未能满足测试结束标准。仅考虑了85种可接受的肺活量测试。儿科医生办公室和PF实验室进行的肺活量测试之间的一致性对于关键参数（强制肺活量，1秒内强制呼气量和强制呼气流量在25％至75％之间）是有利的。 1秒内强制呼气量的可重复性系数为0.26 L（85个值中的83个值在此范围内），强制肺活量（0.3个值在该范围内）为0.30 L，25之间的强制呼气流量为0.58 L / s。 ％和75％（82个值在此范围内）。在79％的病例中，初级保健儿科医生正确地解释了肺活量测定法。在儿科初级保健中进行肺活量测定似乎是合理的，但建议采用涉及初级保健儿科医生和经认证的儿科呼吸内科中心的综合方法，因为有效的培训和质量保证是成功进行肺活量测定的重要前提。
展开▼
