Quality of spirometry tests done in primary care units in the province of Gipuzkoa

Objective. To determine the validity of Spirometry tests done in primary care in our province and to find in what parts of the test errors are committed. Design. Transversal, descriptive study. Setting. All the primary care units in the province of Gipuzkoa, Spain. Participants. Thirty of the 44 existing units took part, contributing the last 10 spirometry tests conducted in November, 2005. Main measurements. Two primary care doctors who were skilled in spirometry analysed the acceptability, reproducibility, possible utility of invalid tests and their spirometric patterns. They also looked at aspects of the curve that were not sufficient. Tests were considered acceptable, reproducible and possibly useful when the 2 doctors coincided. Where they did not coincide, these characteristics were determined by a pneumologist. The validity criteria of the ATS were followed. Results. Of the 44 units in our province, 30 took part. They contributed 300 spirometry tests, of which 12 were excluded as illegible. A total of 48% were considered acceptable, 78% met reproducibility criteria and 38.5% met both characteristics. The most common error was the scant length of exhalation, insufficient in 38.19% of cases. The most usual pattern found was the normal one with 58%, followed by the restrictive with 18%, the obstructive with 13%, and the mixed one, with 11%. Conclusions. Quality of spirometry tests in primary care is deficient. The most common error is that exhalation is too brief We think this is why we find a predominance of restrictive patterns over obstructive ones. Just by prolonging the spirometry operation, we would manage to increase markedly the number of valid tests.