In recent years, pulmonologists have made progress in defining normal vs abnormal lung function, leading to updated standards for the use and interpretation of pulmonary function tests (PFTs).

A panel of experienced pulmonologists will help clinicians navigate current PFT guidance, address controversial issues, and answer unresolved questions from their daily practice during Current Controversies in Pulmonary Function Test Interpretation, on Wednesday, from 8:30 am to 9:30 am, in Room 312 of the convention center.

The session will specifically address areas of uncertainty stemming from updated recommendations published last year by the American Thoracic Society (ATS) and European Respiratory Society (ERS), said Session Chair, Thomas DeCato, MD, FCCP, Assistant Clinical Professor of Medicine at the David Geffen School of Medicine at UCLA and Medical Director of the Pulmonary Function Testing and Exercise Physiology Laboratory at Harbor-UCLA Medical Center.

“Pulmonary function tests are a key component in the diagnosis and management of patients with respiratory disease, and, while this topic always holds great importance in the care of patients, it is of particular interest now given advancements in our understanding and use of PFTs and subsequent recommended changes to interpretation made in the joint ATS/ERS publication,” Dr. DeCato said. “Despite these updated recommendations, several questions arise when considering reference value equations to use, for example, and in classifying physiological impairments.”

Dharani Kumari Narendra, MD, of Baylor College of Medicine, will provide clarity on what qualifies as a clinically significant bronchodilator response. Aaron Baugh, MD, of the University of California, San Francisco, will address the application of race- and ethnicity-based corrections in spirometry. Matthew Hegewald, MD, FCCP, of the University of Utah, will guide attendees through best practices for identifying airway obstruction in spirometry. And Alexander Niven, MD, FCCP, of the Mayo Clinic, will explore the differences between and applicability of preserved ratio impaired spirometry and the nonspecific pattern.

“With rare exception, a PFT on its own does not establish a diagnosis,” Dr. DeCato said. “Uncertainty in interpretation will exist, especially when near the lower limit of normal, so the pretest probability of disease is important to consider when interpreting a pulmonary function test in these circumstances.”