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SpirXpert is software that generates evaluations of spirometric data obtained in patients during a forced expiration. The consensus group which designed the algorithms and the assessments underlines that these evaluations should be regarded as a help. The final evaluation of spirometric data, and any decisions about diagnosis, treatment and other interventions in patients remain the sole responsibility of the physician in charge of the patient, who should come to a conclusion on the basis of information from various sources, of which spirometric data form a part.
- The automatically generated evaluations are based solely on the FEV1 and the FVC or IVC before and/or after administration of a fast-acting bronchodilator drug; they are standardized for standing height, age and gender, and for ethnic group. Predicted values can be selected by the user from amongst 16 sets for adults, and 13 sets of equations for children and adolescents. These include predicted values for children and adolescents which derive from a large group of European children and adolescents, and from prediction equations for adults recommended by the European Community for Steel and Coal and by the European Respiratory Society. The latter turn out to predict values which are too low for a healthy, nonsmoking Dutch population, and therefore an adjusted set that gives a good fit is also available.
- In a healthy population there is great variation in spirometric values even after taking into account age, height, gender and ethnic group. This underlines the need for putting great emphasis on clinical data and the patient’s previous medical history in interpreting spirometric data. The best predicted value for a patient is the personal reference value, i.e. the value obtained in a clinically optimal period; such personal best values may reveal that values which were within the normal range are not the patient’s optimal values.
- Inspiratory airway obstruction can only
be assessed from inspiratory maneuvers: the FEV1
and the FVC or IVC do not provide information about inspiratory
airflow limitation.
Spirometric findings are non-specific and therefore not pathognomonic for a certain diagnosis. Thus an obstructive expiratory syndrome or a restrictive ventilatory defect may be due to a variety of diseases of the respiratory tract. - Spirometric data can be used to exclude a restrictive ventilatory defect. They should not be used to diagnose restrictive lung disease, because this requires measurement of the total lung capacity.
- The response to a bronchodilator drug provides a picture at a given moment in time, and may differ from day to day.