Section 2 Selecting a Spirometer

List of Currently Available Spirometers

The features, specifications, manufacturer and Australian distributor of the diagnostic spirometers currently available in Australia are summarised in Spirometer Features ~ Brief table and Spirometer Features ~ Additional table. All the spirometers listed conform to acceptable minimum spirometer standards (ie American Thoracic Society or European Respiratory Society) and have a warranty period.

All information was supplied by the distributor/manufacturer and was compiled in August 2004. The inclusion of a spirometer does not imply endorsement by the authors. Most spirometers have additional features to those listed but may not have been included due to limited space. Also note that the table represents a summary of detailed information provided by the manufacturers. This information will be updated annually on the website.

Factors to Consider When Purchasing a Spirometer

Ease of use.
Provision of real-time graphic display of the manoeuvre.
Provision of immediate quality feedback concerning the acceptability of blows, including reproducibility.
Provision to interface with clinical software packages.
Provision of customisable final spirometry report.
Provision to print the final report.
Price and running costs.
Reliability and ease of maintenance.
Training, servicing and repair provided by supplier.
Ability to trial the spirometer in your setting before you purchase.
Provision of a disposable sensor or a breathing circuit that can be easily cleaned and disinfected.
Provision of appropriate normal reference values with lower limits of normal.
Robustness.
Provision of a comprehensive operators manual.
Calibration requirements.
Conform to accepted spirometry performance standards.
Safety.

How to use the Tables

List the features and specifications you require and then go to the brief table to determine which spirometer(s) provide these. Then go to the additional table to find out about extra features once you have a ‘short list’ of potential spirometers. It is strongly recommended that you trial the spirometer before buying to ensure that it meets your specific needs.

Brief table

Feature / Specification	Explanation
Model and name	Identifies spirometer by model number and name.
Indices measured	Provides a list the main spirometric indices (eg FEV₁, FVC) measured and printed/displayed by the spirometer.
Real-time display of each blow	Indicates whether a graphic display of the blow (eg flow-volume and/or volume-time curve) is available as the subject performs the test.
Feedback about test quality	Indicates whether the spirometer provides feedback to the operator about the quality of the test – after the blow.
Flow-volume displayed & printed	Indicates whether the spirometer displays and prints the flow-volume curve (or volume-time curve).
Volume-time printed	Indicates whether the spirometer prints the volume-time curve (useful for determining test acceptability).
Quantifies post bronchodilator change	Indicates whether any change in spirometry values post bronchodilator administration is printed on the final report to facilitate interpretation of the significance of bronchodilator response.
Prints predicted flow volume curve	Indicates whether the predicted flow-volume (or volume-time) curve is printed on the final report to facilitate interpretation of measured curve.
Includes interpretation software	Indicates if the spirometer includes software for automatic clinical interpretation of the results.
Results download to clinical software	Indicates whether the test results (numeric and/or graphic) are potentially available for download to another database (eg Medical Director).
Patient result storage capacity	Indicates whether the results are stored and how many individual patient results can be stored by the spirometer.
Portable/not portable	Indicates the size of spirometer.
Power source (mains/battery/both)	Describes power source needed to operate the spirometer (eg batteries).
Is external PC required	Indicates whether the spirometer needs an external computer (not supplied) to run a spirometry test.
Is there an internal printer	Indicates whether there is an internal printer. If not an external printer (not supplied) is required to obtain a printed copy of the results.
Retail Price ($A) spirometer	Estimated retail price of the spirometer in Australia (does not include external PC or external printer).
Cost ($A) consumables per test	This is the estimated retail cost of consumables per patient (eg mouthpieces, other disposable items).

Additional table key

Feature / Specification	Explanation
Daily calibration check recommended	Indicates whether the manufacturer recommends that the spirometer requires its calibration to be adjusted or checked on a daily basis.
Automatically adjusts calibration	Indicates whether the spirometer automatically adjusts the accuracy of the spirometer after calibration, or whether the adjustment can only be carried out by the distributor or manufacturer.
Includes patient feedback during blow	Indicates whether visual feedback is provided to encourage maximum performance – during the blow.
Can provide lower limit of normal	Indicates whether an estimate of the lower limit of the expected normal value is printed on the final report to facilitate interpretation of the measured value.
Can select reference equations	Indicates that operator can select from a number of normal reference equations.
Can adjust for ethnicity	Indicates that the reference values can be adjusted for ethnicity.
Infection control precautions	Indicates suggested method to minimise the risk of patient cross-infection (eg can be cleaned and disinfected; or a disposable sensor is used).
Trial spirometer available	Indicates if spirometer supplier is willing to provide a spirometer for trial to potential purchasers.
Training provided on purchase	Indicates whether the spirometer supplier will provide basic training on the use of the spirometer on purchase.
User manual	Indicates whether the spirometer is supplied with an operators manual.
Provides serial report	Indicates whether the results from previous tests on a patient can be incorporated into the current report.
Weight	Indicates total weight of spirometer.
Spirometer size (H x W x D) cm	Physical dimensions.
On-site or off-site service	Indicates whether the servicing/repair can be provided at your clinic (on-site) or whether it must be returned to the distributor/ manufacturer (off-site).
Sensor type	Describes the physical principle used to measure flow (and volume).
Other features	Describes other features or specifications considered important by the manufacturer.

Reference values

Australian reference values are now available on some spirometers and these may most closely approximate the population you are testing. However, depending on the ethnic mix of people in your local environment other reference values may be more appropriate. If you are unsure which reference values to use contact your local respiratory laboratory.