Richard Casaburi

This is a document produced by a joint ATS-ERS Task Force on lung function testing to provide new combined standards for Spirometry. It walks the reader through all the important elements of the test, from instrument to procedure quality control. One of the major steps forward is the recommendation that a standardised computer output format should be available on all instruments. This does not require equipment manufacturers to store their data in a specific format, but it does require them to provide a means of delivering the data in a standard way. This means that users won't be tied to a specific manufacturer in order to maintain their database structure. It also means that it will be relatively easy to write software to move spirometric data into healthcare databases where they can be used to monitor and guide therapy for patients with lung diseases. Such data can also be used for clinical research, including research into the efficacy of using pulmonary function tests in managing patients. Furthermore, International Organization for Standardization metrology terminology (www.iso.org) has been adopted.

This section is written to provide guidance in interpreting pulmonary function tests (PFTs) to medical directors of hospital-based laboratories that perform PFTs, and physicians who are responsible for interpreting the results of PFTs most commonly ordered for clinical purposes. Specifically, this section addresses the interpretation of spirometry, bronchodilator response, carbon monoxide diffusing capacity (DL,CO) and lung volumes.

BACKGROUND: Pulmonary rehabilitation is recognized as a core component of the management of individuals with chronic respiratory disease. Since the 2006 American Thoracic Society (ATS)/European Respiratory Society (ERS) Statement on Pulmonary Rehabilitation, there has been considerable growth in our knowledge of its efficacy and scope. PURPOSE: The purpose of this Statement is to update the 2006 document, including a new definition of pulmonary rehabilitation and highlighting key concepts and major advances in the field. METHODS: A multidisciplinary committee of experts representing the ATS Pulmonary Rehabilitation Assembly and the ERS Scientific Group 01.02, "Rehabilitation and Chronic Care," determined the overall scope of this update through group consensus. Focused literature reviews in key topic areas were conducted by committee members with relevant clinical and scientific expertise. The final content of this Statement was agreed on by all members. RESULTS: An updated definition of pulmonary rehabilitation is proposed. New data are presented on the science and application of pulmonary rehabilitation, including its effectiveness in acutely ill individuals with chronic obstructive pulmonary disease, and in individuals with other chronic respiratory diseases. The important role of pulmonary rehabilitation in chronic disease management is highlighted. In addition, the role of health behavior change in optimizing and maintaining benefits is discussed. CONCLUSIONS: The considerable growth in the science and application of pulmonary rehabilitation since 2006 adds further support for its efficacy in a wide range of individuals with chronic respiratory disease.

This is a document produced by a joint ATS-ERS Task Force on lung function testing to provide new combined standards for lung volume measurements. It largely reflects a document that was produced after an international workshop held in 1990, funded by the National Heart Lung and Blood Institute (NHLBI). That document was very large and never published in full print, but those interested in all the details can find it posted on the ATS website. In the new document, the relevant technical aspects and the limitations of the methods currently available for lung volume measurements are summarised in a user-friendly way. The position of lung volume measurements in the diagnosis of respiratory disorders and their cost-to-benefit ratio were probably the most controversial aspects of the Task Force.