ERS/ATS Spirometry Standard - Standardization of Spirometry 2019 Update / Series

As you are probably aware, the much anticipated update to the 2005 edition of Standardization of Spirometry was released in October 2019. We have carefully read through the document, and here are what we think are the major changes brought about by the 2019 edition:

• Maximum permissible accuracy error of ±2.5% (additional ±0.5% with 3-L syringe tolerance accounted for).
• Must meet requirements laid out in ISO 26782.
• Stress on the importance of maximal inspiration after maximal expiration for the FVC maneuver, known as the maximal expiratory flow-volume loop in the previous edition.
• End of test (EOT) is now renamed end of forced expiration (EOFE) with significant changes of criteria.
• FEV1 and FVC are always quality controlled and graded separately.
• Usability criteria are defined in addition to acceptability criteria for FVC maneuver.
• New quality grading system with the addition of grades E and U.
• Audio as well as visual feedback must be provided at key quality events such as when plateau is reached.
• A standardized operator comment function is now required.
• Strengthened requirements for bronchodilator responsiveness testing.
• PEF and MVV sections removed from the previous edition.

Fortunately, ndd has already fulfilled some of the new requirements such as equipment accuracy, compliance with ISO 26782, flow-volume loop maneuver and the standardized commenting function.

To better illustrate the details of the 2019 update, we will provide in-depth analysis on the following sections which you can expect to feature in the future ndd news:

1. General equipment requirement and ISO 26782
2. FVC maneuver with maximal inspiration and EOFE criteria
3. The new quality grading system
4. Report parameters
5. New criteria for slow VC maneuver and bronchodilator responsiveness testing
6. Newly required usability features