ESTES PARK, COLO. – The new generation of portable, user-friendly spirometry devices is likely to gain widespread acceptance among primary care physicians, one pulmonary expert predicted.
"Every subspecialist has their fifth vital sign. Mine is spirometry. Some of these handheld spirometers are really easy to use, and I think they’re going to make their way into office practice," said Dr. Robert L. Keith, professor of medicine at the University of Colorado, Denver.
Spirometry is a tool crucial to diagnosing chronic obstructive pulmonary disease in symptomatic patients. Plus, the forced expiratory volume in 1 second (FEV1) as measured using spirometry is the guideline-recommended means of categorizing patients as to disease stage and the most appropriate choice of treatment in individuals with COPD (Ann. Intern. Med. 2011;155:179-91).
Dr. Robert L. Keith
Moreover, spirometry also provides an objective way to assess the effectiveness of treatment, the pulmonologist observed at a conference on internal medicine sponsored by the university.
"One of the neat things about the new software is it can provide quick data on lung age," Dr. Keith explained. "I can see a guy and tell him, ‘I’ve got your spirometry results, and your FEV1 is 41% and your FEV1/forced vital capacity ratio is 0.5,’ and he’s looking at me like, ‘What does that mean, doc?’
"But if I can say, ‘You’re 61 years old and your lungs are 75,’ that’s a take-home message pretty much anyone can understand," said Dr. Keith.
"I also use spirometry to follow patients, so I can say, ‘You’ve quit smoking and are using your medications, and guess what? Your lung age has improved from 75 to age 70,’ " he added.
Examples of state-of-the-art handheld spirometry devices on the market today include the Vitalograph copd-6, the PulmoLife, and PiKo-6, Dr. Keith noted.
"We tend to have a very rural population in Colorado that flows into Denver to be seen at the VA," [Veterans Affairs] he explained. "We give patients handheld spirometers to take back home to measure their disease and report in about their lung function."
Peak expiratory flow rate underestimates COPD severity, Dr. Keith cautioned, and cannot be used to diagnose COPD. Instead, peak expiratory flow is a spirometry measurement used as a tool in managing asthma.
He reported serving on speakers bureaus for Pfizer and Boehringer-Ingelheim.