Certain Patient Characteristics May Be Linked to Spirometry Test Failure

Woman using a spirometry
Woman using a spirometry
In field-based studies, coaching those who administer spirometry tests may help reduce test failure rates among certain populations.

Researchers for a prospective study on the health effects of a major oil spill found that spirometry test failure was associated with some definable participant characteristics, according to a study published in Respiratory Medicine.

The Gulf Long-Term Follow-up (GuLF) Study (ClinicalTrials.gov Identifier: NCT01287000) is a cohort study on the health effects associated with the oil spill response and clean-up following the Deepwater Horizon Disaster in 2010. In this study, spirometry testing of lung function was carried out in home visits across multiple states in the United States (Louisiana, Mississippi, Texas, Alabama, Florida). Researchers sought to identify what factors, if any, predicted spirometry test failure among GuLF Study participants who completed spirometry testing at home.

Failure to perform reproducible spirometry may be an indicator of respiratory ill health.

However, spirometry is also known to be highly influenced by participant effort, participant-examiner cooperation, and examiner proficiency as a spirometry “coach.”

Likewise, many studies have found that certain participant factors may increase the likelihood of spirometry test failure or success.

In the recent study, trained examiners administered in-home spirometry testing (from May 2011 through May 2013) to 10,019 participants living in the Gulf States using an ultrasonic spirometer. Investigators used American Thoracic Society/European Respiratory Society quality criteria to determine tests results considered to be failures due to insufficient quality. Stepwise and regression analysis were used to identify factors predictive of failure.

The analysis found that participants who self-reported Black race, male gender, and making less than $50,000 per year were more likely to fail testing. Conversely, participants who were obese (BMI ≥25) were less likely to fail testing.

The authors concluded, “Field-based studies involving spirometry should identify and account for participant factors that may influence test failure.” They added, “Coaching that is tailored to those less likely to have experience with spirometry may help reduce test failure rates.”


Lawrence KG, Jackson II WB, Ramsey S, et al. Spirometry quality predictors in a large multistate prospective study. Respir Med. Published online September 17, 2021. doi:10.1016/j.rmed.2021.106618