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Instrument Accuracy and Reproducibility in Measurements of Pulmonary Function^*

^* From LDS Hospital (Drs. Jensen and Crapo), Salt Lake City, UT; and Pfizer Global Research and Development (Drs. Teeter, England, White, and Pickering), Groton, CT.

Correspondence to: Robert L. Jensen, PhD, Pulmonary Laboratory, LDS Hospital and University of Utah, Eighth Ave and C St, Salt Lake City, UT 84143; e-mail: ldrjens1{at}ihc.com

Abstract

Background: The objective of the study was to quantify the accuracy and reproducibility of five commercially available pulmonary function test (PFT) instruments (Collins CPL [Ferraris Respiratory; Louisville, CO]; Morgan Transflow Test PFT System [Morgan Scientific; Haverhill, MA]; SensorMedics max 22D [VIASYS Healthcare; Yorba Linda, CA]; Jaeger USA Masterscreen Diffusion TP [VIASYS Healthcare]; and Medical Graphics Profiler DX System [Medical Graphics Corp; St. Paul, MN]) that are associated with spirometry and the measurement of pulmonary diffusing capacity.

Methods: In a multifactor, single-center, repeated-measures, full factorial 90-day study, a pulmonary waveform generator and a single-breath simulator of diffusing capacity of the lung for carbon monoxide (DLCO) were used to perform simulations of FVC and DLCO maneuvers. Accuracy was assessed as the difference between the observed and simulated values. Reproducibility was determined as the coefficient of variation of all measurements made during the study.

Results: All instruments demonstrated a high degree of accuracy in the measurement of FVC and FEV₁. Overall, the accuracies associated with the measurement of peak flow, forced expiratory flow, mid-expiratory phase, and diffusing capacity were generally lower and more variable among the instruments tested. The coefficients of variation of DLCO measurements over 90 days were higher than those observed for spirometry.

Conclusions: This study demonstrates the feasibility of assessing the accuracy and reproducibility of modern PFT instruments using simulation testing. Our results provide an assessment of the component of PFT accuracy and reproducibility that is due to instrumentation alone.

Key Words: diffusing capacity of the lung for carbon monoxide simulator • pulmonary function testing • pulmonary waveform generator

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