General consideration for lung testing. ATS/ERS Task Force on "Standardization of Spirometry, Lung Volumes and Diffusing in Capacity"

Since 1979, guidelines for standardising pulmonary function tests have been published and updated by both the American Thoracic Society (ATS) and the European Respiratory Society (ERS). In addition, several joint ATS/ERS workshops on pulmonary function testing have been held and the resulting reports published. In 1995, European scientists participated in the ATS updates of standards for spirometry and single-breath carbon monoxide diffusing capacity of the lung (DL,CO), but no joint statement has been published by the two societies. Although generally concordant, the spirometry and DL,CO guidelines published separately by the ATS and the ERS differed in some aspects that were of appreciable importance. Official guidelines for the measurement of lung volumes were made available by the ERS, but not the ATS. In recent years, global initiatives were undertaken for the diagnosis and treatment of pulmonary diseases, and the worldwide market for instruments to test lung function widened considerably. This increased the pressure for more uniform pulmonary function testing across the world, and prompted the ATS and the ERS to appoint a joint Task Force to provide new combined standards for clinical pulmonary function testing, with the hope that they will be accepted by other respiratory societies. A new Task Force on pulmonary function testing, implemented by the Forum of International Respiratory Societies (FIRS), has recently started its work based on the ATS/ERS documents. Our Task Force consisted of 19 scientists with recognised expertise in pulmonary function testing. The group worked on a ''one-draft'' system, in which each of five sections was assigned to a small subgroup and eventually discussed by the whole committee. There was a general feeling that previous standards published by the two societies tended to be difficult to use because of their overwhelming details and the lack of a user-friendly indexing system. Therefore, one of the goals was a change in format, including a more comprehensive indexing system. We worked hard to make it easy for people to quickly find what they need. From its beginning in 2001 (a ''new millennium project'') to the final approval in 2005, the Task Force met many times and had some tough negotiations, both face to face and by e-mail or conference call. We count it as one of our successes that all participants stayed in the process until reasonable solutions were found. As agreed, the new standards are due to appear as a series in five consecutive issues of the European Respiratory Journal, starting from the current one, which discusses general considerations for lung function testing.