Continuing education in spirometry: a light along the way.

Despite the diverse nature of chronic respiratory diseases, their clinical expression is rather limited in symptoms, so their manifestation may be overlapping. For this reason, the differential diagnosis of chronic lung disease requires additional tests that help the clinician to differentiate some diseases from others. Among these complementary studies, chest radiology (as an anatomical study) and pulmonary function tests (as functional assessment) are particularly relevant. Of the latter, spirometry has acquired a leading role as the first functional assessment in patients with respiratory diseases, since despite its simplicity, it provides comprehensive information on the lung physiology. However, although spirometry is a simple, non-invasive, reliable and safe technique, numerous studies have shown that there are problems with underuse1 and variability in the quality of spirometry performed.2 The causes of this inadequate use of spirometry are multiple, and have probably contributed notably to the underdiagnosis of chronic respiratory diseases in the general population.3 In this issue of Archivos de Bronconeumología, Roger et al.4 studied the use of spirometry in 65 public hospitals using a cross-sectional survey. The survey collected information on relevant aspects of spirometry, such as the number, type of spirometry, site where they were performed and information on the professionals who carried them out and their training, among others. In the results analysis, the authors observed irregular use of spirometry in these centres,4 and identified the quality control of the test, inclusion of results in hospital data systems and the application of continuing education programmes as the main weak points in the centres studied. Along the same lines, a recently published national study5 corroborates these findings, and also pointed out that the low number of spirometries performed, misuse of the bronchodilator test, inadequate calibration of the device and poor training are the main