Tuberc Respir Dis > Volume 63(5); 2007 > Article
Tuberculosis and Respiratory Diseases 2007;63(5):405-411.
DOI:    Published online November 1, 2007.
Applicability of American and European Spirometry Repeatability Criteria to Korean Adults.
Byung Hoon Park, Moo Suk Park, Woo Young Jung, Min Kwang Byun, Seon Cheol Park, Sang Yun Shin, Han Ho Jeon, Kyung Soo Jung, Ji Ae Moon, Se Kyu Kim, Joon Chang, Sung Kyu Kim, Song Vogue Ahn, Yeon Mok Oh, Sang Do Lee, Young Sam Kim
1Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
2Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea.
3The Institute of Chest Diseases, Yonsei University College of Medicine, Seoul, Korea.
4Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
5Clinical Research Center for Chronic Obstructive Airway Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
The objective of this study was to evaluate the clinical applicability of the repeatability criteria recommended by the American Thoracic Society/European Respiratory Society (ATS/ERS) spirometry guidelines and to determine which factors affect the repeatability of spirometry in Korean adults. METHODS: We reviewed the spirometry data of 4,663 Korean adults from the Korean National Health and Nutritional Examination Survey (KNHANES) Chronic Obstructive Pulmonary Disease Cohort (COPD cohort) and the Community-based Cohort Study VI-Fishing village/Islands (community cohort). We measured the anthropometric factors and differences between the highest and second-highest FVC (dFVC) and FEV1 (dFEV1) from prebronchodilator spirometry. Analyses included the distribution of dFVC and dFEV1, comparison of the values meeting the 1994 ATS repeatability criteria with the values meeting the 2005 ATS/ERS repeatability criteria, and the performance of linear regression for evaluating the influence of subject characteristics and the change of criteria on the spirometric variability. RESULTS: About 95% of subjects were able to reproduce FVC and FEV1 within 150 ml. The KNHANES based on the 1994 ATS guidelines showed poorer repeatability than the COPD cohort and community cohort based on the 2005 ATS/ERS guidelines. Demographic and anthropometric factors had little effect on repeatability, explaining only 0.5 to 3%. CONCLUSION: We conclude that the new spirometry repeatability criteria recommended by the 2005 ATS/ERS guidelines is also applicable to Korean adults. The repeatability of spirometry depends little on individual characteristics when an experienced technician performs testing. Therefore, we suggest that sustained efforts for public awareness of new repeatability criteria, quality control of spirograms, and education of personnel are needed for reliable spirometric results.
Key Words: Spirometry, Repeatability, Quality control

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