From the Guidelines
If the American Thoracic Society (ATS) criteria for spirometry are not met, it means the spirometry test results may not be reliable for clinical decision-making. The ATS criteria are essential for ensuring the accuracy and reliability of spirometry test results, which are crucial for diagnosing and managing respiratory conditions. According to the standardisation of spirometry document 1, the ATS criteria include technical standards such as adequate effort by the patient, proper test duration, acceptable start of test, smooth continuous exhalation, and absence of artifacts like coughs or glottic closure.
When ATS criteria aren't met, the test should typically be repeated to obtain accurate results. Non-adherence to these criteria can lead to inaccurate measurements of lung function parameters such as FEV1 (forced expiratory volume in one second) and FVC (forced vital capacity). Some key points to consider when ATS criteria are not met include:
- The test results may not accurately reflect the patient's lung function
- Inaccurate results can lead to inappropriate diagnosis or management of respiratory conditions
- The reliability of spirometry depends on proper technique, equipment calibration, and patient cooperation
- Clinicians should be cautious about making treatment decisions based on spirometry that doesn't meet ATS criteria.
The standardisation of spirometry is crucial for ensuring the accuracy and reliability of test results, and the ATS criteria play a vital role in this process 1. By following these criteria, clinicians can ensure that spirometry test results are reliable and accurate, which is essential for making informed treatment decisions and improving patient outcomes.
From the Research
ATS Criteria for Spirometry
The American Thoracic Society (ATS) criteria for spirometry are a set of standards used to ensure the quality and accuracy of spirometry tests. These criteria include acceptability and repeatability standards for spirometric measurements such as Forced Expiratory Volume in one second (FEV1) and Forced Vital Capacity (FVC) 2.
Meaning of Not Meeting ATS Criteria
If the ATS criteria for spirometry are not met, it means that the spirometry test does not meet the standards for acceptability and repeatability. This can be due to various factors such as:
- Errors in test performance, such as inadequate expiration time or excessive back-extrapolated volume 2
- Patient characteristics, such as inability to perform the test correctly or presence of certain lung diseases 2
- Technical issues with the spirometry equipment 3
Implications of Not Meeting ATS Criteria
Not meeting the ATS criteria for spirometry can have significant implications, including:
- Reduced accuracy and reliability of spirometric measurements 2
- Difficulty in diagnosing and monitoring lung diseases 3
- Potential for misinterpretation of test results 4
Studies on ATS Criteria
Several studies have investigated the ATS criteria for spirometry, including:
- A study published in 2014, which found that nearly 15% of subjects failed to fulfill all the ATS/ERS 2005 criteria for spirometry despite being coached by a qualified technician 2
- A study published in 2019, which updated the technical standards for spirometry and provided recommendations for manufacturers, clinicians, and researchers 3
- A study published in 2023, which investigated the acceptability and repeatability criteria of spirometry performed under occupational field conditions and found that spirometry can be performed with reliable quality in an occupational field setting 5
Key Findings
Key findings from these studies include:
- The importance of meeting the ATS criteria for spirometry to ensure accurate and reliable test results 2, 3
- The need for proper training and coaching of technicians and patients to ensure that the test is performed correctly 2, 5
- The potential for technical issues with spirometry equipment to affect test results 3