Feasibility and validation of telespirometry in general practice: The Italian "Alliance" study

Respir Med. 2009 Nov;103(11):1732-7. doi: 10.1016/j.rmed.2009.05.006. Epub 2009 Jun 4.


Introduction: At variance from office spirometry, telespirometry has not been tested as a tool for improving the ability of general practitioners (GPs) to manage chronic airway diseases.

Methods: After adequate training, 937 Italian GPs agreed to perform telespirometry in subjects attending their clinics who had risk factors, persistent respiratory symptoms, or a previous diagnosis of asthma or COPD. Each subject performed at least three forced expiratory manoeuvres using a turbine spirometer. Traces were sent by telephone to a Telespirometry Central Office, where they were interpreted by a pulmonary specialist, according to defined criteria. The result was sent in real time to the GP to assist the management of the patient.

Results: During 2 years, 20,757 telespirometries were performed, with a mean of 22.2+/-25.2 examinations for each GP. 70% of the tests met the criteria for good or partial co-operation, allowing spirometric abnormalities to be detected in more than 40% of the tracings. The rate of telespirometries that could not be evaluated at all was reasonably low (9.2%). For a subset of the telespirometries, a comparison between acceptability criteria for telespirometry and those recommended for laboratory (ATS) or office spirometry showed that the majority of telespirometries with good co-operation satisfied completely, or with minor deviations, the ATS and Office criteria.

Conclusions: Telespirometry was well accepted by Italian GPs, who obtained acceptable screening traces in a large percentage of subjects. Therefore it might be considered a useful alternative to office spirometry in improving the management of chronic airway diseases by GPs.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't
  • Validation Study

MeSH terms

  • Adult
  • Asthma / diagnosis*
  • Asthma / therapy
  • Clinical Competence
  • Family Practice / methods*
  • Feasibility Studies
  • Female
  • Humans
  • Italy
  • Male
  • Middle Aged
  • Physicians, Family
  • Pulmonary Disease, Chronic Obstructive / diagnosis*
  • Pulmonary Disease, Chronic Obstructive / therapy
  • Quality Assurance, Health Care
  • Risk Factors
  • Spirometry / instrumentation
  • Spirometry / methods*
  • Telemedicine / instrumentation
  • Telemedicine / methods*
  • Treatment Outcome