The Science Journal of the American Association for Respiratory Care

Original Contributions

October 2002 / Volume 47 / Number 10 / Page 1150

Performance of a New Screening Spirometer at a Community Health Fair

Robin J Schoh MSc MBA, Laura J Fero RN, Howard Shapiro PhD, Jordan P Aslor MBA RPFT, Oscar J Kaelin MSEE, Donald R Rollins MD, and Thomas L Petty MD

OBJECTIVE: Compare the results from a new screening spirometer (EasyOne) with the results from a standard laboratory spirometer (Vmax) approved by the American Thoracic Society. SETTING: A health fair at a community hospital. METHODS: We measured forced expiratory volume in the first second (FEV1) and forced expiratory volume in the first 6 seconds (FEV6). With the screening spirometer, good quality testing was achieved in 359 of 394 subjects (91%), and 115 subjects were also tested with the standard laboratory spirometer. The best test values for FEV1 and FEV6 were taken for 3 tests that agreed within 3%. FEV6 was extrapolated from forced vital capacity on the printouts from the standard laboratory spirometer. RESULTS: Correlations between the screening spirometer results and the standard laboratory spirometer were excellent for FEV1 (r = 0.93), FEV6 (r = 0.96), and FEV1/FEV6 (r = 0.72) (p = 0.001 for all comparisons). The 95% limits of agreement (mean difference between the 2 spirometers ± 1.96 standard deviations) were: -0.18 and 0.69 for FEV1; -0.24 and 0.81 for FEV6; and -0.12 and 0.13 for FEV1/FEV6. CONCLUSION: The new screening spirometer is suitable for clinical use.
Key words: screening, spirometry, spirometer, EasyOne, SensorMedics, Vmax, health fair.
[Respir Care 2002;47(10):1150–1157]

Introduction

Screening for occult disease is commonplace in the United States. Community-sponsored health and wellness programs often offer tests for blood pressure, eyesight, hearing, cholesterol, diabetes, osteoporosis, breast, colon, and prostate cancer, and tests for less common disorders. Such screening is often conducted at community health fairs. Spirometry screening is sometimes done at such events.

Since spirometry is predictive of risk of death from heart attack, stroke, lung cancer, chronic obstructive pulmonary disease, and all-cause mortality, it is an appropriate addition to community health screening projects. One previous community project offered spirometric screening to the entire metropolitan population of Denver, Colorado, on a single day. In fact, 2,586 patients were tested at multiple locations during two 4-hour periods on 2 separate Saturday mornings. Follow-up showed that such screening, using a new and previously validated electric spirometer, yielded credible results.

See the Related Editorial on Page 1145

A new national health care initiative recommends routine spirometry screening of all smokers over age 45 and of anyone with chronic cough, mucus hypersecretion, dyspnea on exertion, or wheeze. That initiative is called the National Lung Health Education Program (NLHEP).

In response to the NLHEP several spirometer manufacturers have developed and marketed new, simple, accurate, and inexpensive hand-held spirometers for the purpose of promoting widespread spirometric screening. One such new device (EasyOne, ndd Medical Technologies, Andover, Massachusetts) meets American Thoracic Society standards and has United States Food and Drug Administration approval. We used several EasyOne spirometers at a Saturday-morning community health fair (2 sessions, 4 weeks apart). We aimed to validate the performance of the new spirometer and its agreement with an established American Thoracic Society-approved spirometer (Vmax, VIASYS Healthcare/SensorMedics, Yorba Linda, California) that is commonly used in pulmonary function laboratories today.

The purpose of this report is to document the performance of the EasyOne device and its agreement with the Vmax spirometer. A secondary aim was to learn the number of abnormal spirometry measurements detected at such a health fair event. A later study will evaluate whether the finding of new spirometric abnormalities resulted in any behavioral changes in subjects whose spirometry was abnormal.

The entire text of this article is available in the printed version of the October 2002 RESPIRATORY CARE.

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