Letter to the Editor
Training of Primary Care Health Professionals and Quality in Spirometry
Formación de los profesionales de atención primaria y calidad en la espirometría
Alberto Fernández Villar
, Cristina Represas Represas
Corresponding author
Servicio de Neumología, Área de Xestión Integrada de Vigo, Instituto de Investigación Biomédica de Vigo, Vigo, Pontevedra, Spain
Read
5069
Timeswas read the article
1909
Total PDF
3160
Total HTML
Share statistics
array:24 [ "pii" => "S1579212914001190" "issn" => "15792129" "doi" => "10.1016/j.arbr.2014.01.011" "estado" => "S300" "fechaPublicacion" => "2014-06-01" "aid" => "912" "copyright" => "SEPAR" "copyrightAnyo" => "2014" "documento" => "simple-article" "crossmark" => 0 "subdocumento" => "cor" "cita" => "Arch Bronconeumol. 2014;50:259" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 2194 "formatos" => array:3 [ "EPUB" => 106 "HTML" => 1557 "PDF" => 531 ] ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S0300289614000581" "issn" => "03002896" "doi" => "10.1016/j.arbres.2014.01.007" "estado" => "S300" "fechaPublicacion" => "2014-06-01" "aid" => "912" "copyright" => "SEPAR" "documento" => "simple-article" "crossmark" => 0 "subdocumento" => "cor" "cita" => "Arch Bronconeumol. 2014;50:259" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 4230 "formatos" => array:3 [ "EPUB" => 108 "HTML" => 3519 "PDF" => 603 ] ] "es" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Carta al Director</span>" "titulo" => "Formación de los profesionales de atención primaria y calidad en la espirometría" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "259" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Training of primary care health professionals and quality in spirometry" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Alberto Fernández Villar, Cristina Represas Represas" "autores" => array:2 [ 0 => array:2 [ "nombre" => "Alberto" "apellidos" => "Fernández Villar" ] 1 => array:2 [ "nombre" => "Cristina" "apellidos" => "Represas Represas" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S1579212914001190" "doi" => "10.1016/j.arbr.2014.01.011" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212914001190?idApp=UINPBA00003Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289614000581?idApp=UINPBA00003Z" "url" => "/03002896/0000005000000006/v1_201405240608/S0300289614000581/v1_201405240608/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S1579212914001219" "issn" => "15792129" "doi" => "10.1016/j.arbr.2013.08.009" "estado" => "S300" "fechaPublicacion" => "2014-06-01" "aid" => "828" "copyright" => "SEPAR" "documento" => "simple-article" "crossmark" => 0 "subdocumento" => "cor" "cita" => "Arch Bronconeumol. 2014;50:260" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 2423 "formatos" => array:3 [ "EPUB" => 123 "HTML" => 1702 "PDF" => 598 ] ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Quality Spirometry: What Do We Base Our Definition On?" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "260" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Calidad en la espirometría, ¿en qué nos basamos para definirla?" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Jordi Giner Donaire" "autores" => array:1 [ 0 => array:2 [ "nombre" => "Jordi" "apellidos" => "Giner Donaire" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0300289613002743" "doi" => "10.1016/j.arbres.2013.08.005" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289613002743?idApp=UINPBA00003Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212914001219?idApp=UINPBA00003Z" "url" => "/15792129/0000005000000006/v1_201405291004/S1579212914001219/v1_201405291004/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S1579212914001189" "issn" => "15792129" "doi" => "10.1016/j.arbr.2014.04.001" "estado" => "S300" "fechaPublicacion" => "2014-06-01" "aid" => "833" "copyright" => "SEPAR" "documento" => "article" "crossmark" => 0 "subdocumento" => "sco" "cita" => "Arch Bronconeumol. 2014;50:258" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 2620 "formatos" => array:3 [ "EPUB" => 140 "HTML" => 1899 "PDF" => 581 ] ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Clinical Image</span>" "titulo" => "Atypical Lung Metastasis" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "258" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Metástasis pulmonar atípica" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:6 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 800 "Ancho" => 954 "Tamanyo" => 127390 ] ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Victoria Mayoral-Campos, Claudia Josa Laorden, José Luis de Benito-Arévalo" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Victoria" "apellidos" => "Mayoral-Campos" ] 1 => array:2 [ "nombre" => "Claudia" "apellidos" => "Josa Laorden" ] 2 => array:2 [ "nombre" => "José Luis" "apellidos" => "de Benito-Arévalo" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0300289613002792" "doi" => "10.1016/j.arbres.2013.09.007" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289613002792?idApp=UINPBA00003Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212914001189?idApp=UINPBA00003Z" "url" => "/15792129/0000005000000006/v1_201405291004/S1579212914001189/v1_201405291004/en/main.assets" ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Training of Primary Care Health Professionals and Quality in Spirometry" "tieneTextoCompleto" => true "saludo" => "<span class="elsevierStyleItalic">To the Editor</span>:" "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "259" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Alberto Fernández Villar, Cristina Represas Represas" "autores" => array:2 [ 0 => array:4 [ "nombre" => "Alberto" "apellidos" => "Fernández Villar" "email" => array:1 [ 0 => "alberto.fernandez.villar@sergas.es" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "Cristina" "apellidos" => "Represas Represas" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicio de Neumología, Área de Xestión Integrada de Vigo, Instituto de Investigación Biomédica de Vigo, Vigo, Pontevedra, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Formación de los profesionales de atención primaria y calidad en la espirometría" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We read with interest the letter to the editor from Dr J. Giner,<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> referring to a recent paper in which we showed the effectiveness of a supervised training program on spirometry for Primary Care professionals.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> We appreciate the comments, and we agree on the importance of ensuring maximum quality in spirometry, including assessment of the validity of the maneuvers and reproducibility of the results. However, we believe that some of the issues discussed in relation to our study should be duly explained.</p><p id="par0010" class="elsevierStylePara elsevierViewall">In our opinion, proper performance and interpretation of spirometry in Primary Care should be a team effort. It should begin with the appropriate indication from the doctor, followed by accurate implementation by the nursing staff, and finish with correct interpretation by both, although the person responsible for the final report will be the physician. It was for this reason that the training program evaluated included teams of doctors and nurses working in the same Primary Care centers, and not professionals of both types working individually. Moreover, for spirometries to be considered correct, the maneuver submitted for evaluation and the test report had to be error-free, and the doctor/nurse team also had to ensure that at least three valid maneuvers were obtained and that the reproducibility criteria recommended by the ERS/ATS<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> were met. This is the equivalent of a grade A (good quality) in the score mentioned by the author. This score is at present included in the most recent SEPAR guidelines that are coincidentally published in the same journal issue as our study.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">We totally agree with Dr. Giner that this is a limitation of the study (we mention this in the Discussion section), since the quality of the spirometries could not be guaranteed due to the lack of verification of acceptability and reproducibility criteria in all the cases reviewed. For this reason, one aspect regarding the evaluation of the tests was modified in subsequent training sessions: the same program was implemented, but students had to print and submit the three valid maneuvers required of each spirometry. Thus, acceptability and reproducibility could be assessed and the quality of the studies could be analyzed. As described in our paper, the results were completely equivalent to those of the earlier sessions. Therefore, we may conclude that successful completion of a supervised training program such as the one we designed and evaluated here, both in the short and long terms, allows most Primary Care teams to improve their theoretical and practical knowledge of spirometry, and to produce very satisfactory rates of high quality spirometric studies.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Fernández Villar A, Represas Represas C. Formación de los profesionales de atención primaria y calidad en la espirometría. Arch Bronconeumol. 2014;50:259.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:4 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Calidad en la espirometría. ¿en qué nos basamos para definirla?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "J. Giner Donaire" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:2 [ "tituloSerie" => "Arch Bronconeumol" "fecha" => "2013" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Efectividad a corto y largo plazo de un programa tutelado de formación en espirometrías para profesionales de atención primaria" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "C. Represas-Represas" 1 => "M. Botana-Rial" 2 => "V. Leiro-Fernández" 3 => "A.I. González-Silva" 4 => "A. García-Martínez" 5 => "A. Fernández-Villar" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.arbres.2013.01.001" "Revista" => array:6 [ "tituloSerie" => "Arch Bronconeumol" "fecha" => "2013" "volumen" => "49" "paginaInicial" => "378" "paginaFinal" => "382" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23481409" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Standardisation of spirometry" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M.R. Miller" 1 => "J. Hankinson" 2 => "V. Brusasco" 3 => "F. Burgos" 4 => "R. Casaburi" 5 => "A. Coates" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1183/09031936.05.00034805" "Revista" => array:6 [ "tituloSerie" => "Eur Respir J" "fecha" => "2005" "volumen" => "26" "paginaInicial" => "319" "paginaFinal" => "338" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16055882" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Normativa SEPAR. Espirometría" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "F. García-Río" 1 => "M. Calle" 2 => "F. Burgos" 3 => "P. Casan" 4 => "F. del Campo" 5 => "J.B. Gáldiz" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Arch Bronconeumol" "fecha" => "2013" "volumen" => "49" "paginaInicial" => "338" "paginaFinal" => "401" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/15792129/0000005000000006/v1_201405291004/S1579212914001190/v1_201405291004/en/main.assets" "Apartado" => array:4 [ "identificador" => "14576" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Letters to the editor" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/15792129/0000005000000006/v1_201405291004/S1579212914001190/v1_201405291004/en/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212914001190?idApp=UINPBA00003Z" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 3 | 2 | 5 |
| 2024 October | 36 | 18 | 54 |
| 2024 September | 47 | 13 | 60 |
| 2024 August | 56 | 27 | 83 |
| 2024 July | 45 | 19 | 64 |
| 2024 June | 47 | 23 | 70 |
| 2024 May | 64 | 31 | 95 |
| 2024 April | 30 | 22 | 52 |
| 2024 March | 38 | 15 | 53 |
| 2024 February | 35 | 22 | 57 |
| 2023 March | 3 | 2 | 5 |
| 2023 February | 28 | 20 | 48 |
| 2023 January | 19 | 24 | 43 |
| 2022 December | 43 | 31 | 74 |
| 2022 November | 38 | 22 | 60 |
| 2022 October | 31 | 29 | 60 |
| 2022 September | 27 | 32 | 59 |
| 2022 August | 30 | 45 | 75 |
| 2022 July | 26 | 41 | 67 |
| 2022 June | 28 | 50 | 78 |
| 2022 May | 28 | 34 | 62 |
| 2022 April | 33 | 27 | 60 |
| 2022 March | 42 | 39 | 81 |
| 2022 February | 28 | 42 | 70 |
| 2022 January | 30 | 38 | 68 |
| 2021 December | 23 | 46 | 69 |
| 2021 November | 26 | 43 | 69 |
| 2021 October | 39 | 38 | 77 |
| 2021 September | 26 | 44 | 70 |
| 2021 August | 26 | 43 | 69 |
| 2021 July | 40 | 55 | 95 |
| 2021 June | 40 | 46 | 86 |
| 2021 May | 35 | 44 | 79 |
| 2021 April | 89 | 90 | 179 |
| 2021 March | 41 | 30 | 71 |
| 2021 February | 26 | 21 | 47 |
| 2021 January | 24 | 22 | 46 |
| 2020 December | 37 | 31 | 68 |
| 2020 November | 19 | 15 | 34 |
| 2020 October | 20 | 20 | 40 |
| 2020 September | 21 | 9 | 30 |
| 2020 August | 84 | 20 | 104 |
| 2020 July | 31 | 33 | 64 |
| 2020 June | 17 | 9 | 26 |
| 2020 May | 27 | 9 | 36 |
| 2020 April | 43 | 23 | 66 |
| 2020 March | 27 | 14 | 41 |
| 2020 February | 29 | 17 | 46 |
| 2020 January | 19 | 12 | 31 |
| 2019 December | 35 | 17 | 52 |
| 2019 November | 22 | 12 | 34 |
| 2019 October | 18 | 10 | 28 |
| 2019 September | 24 | 15 | 39 |
| 2019 August | 27 | 8 | 35 |
| 2019 July | 24 | 8 | 32 |
| 2019 June | 30 | 12 | 42 |
| 2019 May | 23 | 10 | 33 |
| 2019 April | 26 | 26 | 52 |
| 2019 March | 27 | 21 | 48 |
| 2019 February | 26 | 22 | 48 |
| 2019 January | 27 | 16 | 43 |
| 2018 December | 42 | 18 | 60 |
| 2018 November | 72 | 19 | 91 |
| 2018 October | 101 | 18 | 119 |
| 2018 September | 30 | 11 | 41 |
| 2018 May | 13 | 1 | 14 |
| 2018 April | 32 | 4 | 36 |
| 2018 March | 29 | 3 | 32 |
| 2018 February | 31 | 2 | 33 |
| 2018 January | 80 | 8 | 88 |
| 2017 December | 54 | 6 | 60 |
| 2017 November | 10 | 1 | 11 |
| 2017 October | 17 | 7 | 24 |
| 2017 September | 16 | 6 | 22 |
| 2017 August | 13 | 8 | 21 |
| 2017 July | 16 | 5 | 21 |
| 2017 June | 30 | 4 | 34 |
| 2017 May | 18 | 6 | 24 |
| 2017 April | 11 | 5 | 16 |
| 2017 March | 6 | 31 | 37 |
| 2017 February | 11 | 3 | 14 |
| 2017 January | 13 | 3 | 16 |
| 2016 December | 22 | 9 | 31 |
| 2016 November | 25 | 9 | 34 |
| 2016 October | 33 | 9 | 42 |
| 2016 September | 23 | 7 | 30 |
| 2016 August | 34 | 13 | 47 |
| 2016 July | 10 | 6 | 16 |
| 2016 March | 2 | 0 | 2 |
| 2016 February | 1 | 0 | 1 |
| 2015 December | 3 | 0 | 3 |
| 2015 October | 34 | 1 | 35 |
| 2015 September | 35 | 6 | 41 |
| 2015 August | 30 | 9 | 39 |
| 2015 July | 31 | 6 | 37 |
| 2015 June | 24 | 6 | 30 |
| 2015 May | 34 | 6 | 40 |
| 2015 April | 23 | 8 | 31 |
| 2015 March | 27 | 5 | 32 |
| 2015 February | 28 | 4 | 32 |
| 2015 January | 25 | 7 | 32 |
| 2014 December | 33 | 8 | 41 |
| 2014 November | 20 | 8 | 28 |
| 2014 October | 41 | 12 | 53 |
| 2014 September | 24 | 19 | 43 |
| 2014 July | 0 | 2 | 2 |
| 2014 June | 0 | 1 | 1 |
Show all
