Can everyone carry out lung function tests?
Among requirements for carrying out lung function tests are a quiet environment, expertise, being experienced, and sufficient time. Do not carry out spirometric tests if these conditions are not met.
- Test results are dependent upon subject cooperation. Hence FEV1 and FVC can only be underestimated, never overestimated. Unsatisfactory tests may therefore lead to erroneous conclusions, e.g. that the patient has airway obstruction when this is not the case, or the other way around.
- It is therefore indispensable that the patient is clearly instructed and demonstrated what the test entails. Also the subject should be encouraged to perform maximally while carrying out the tests and subsequently be clearly explained what was unsatisfactory, and how this can be remedied. This takes time, patience and understanding. The test needs to be carried out in a quiet environment so as to avoid distraction.
- The person in charge should not be in a hurry and be sufficiently experienced to have the tests carried out properly. Spirometric tests before bronchodilatation take 5 minutes or more. Investigating elderly subjects usually takes more time, patience and empathy than in young adults. Testing children is even more demanding; additionally the environment should be suitable for children.
Clearly spirometric tests cannot be carried
out in a hurry. Usually it cannot be combined with busy office hours.
If, for that reason, testing is delegated to a nurse or other assistant,
that person must fulfill all the above requirements and be able
to fall back on an experienced doctor.
If these conditions are not met it is better to have spirometric tests carried out in well equipped laboratories with professionally trained and experienced personnel; you can then rely on the quality of both measurements and calibrations.