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Spida 5Operating Manual

Micro MedicalPO Box 6

Rochester Kent

England ME1 2AZ

Drg No: - 055-01Revision 2.7 June 07

Version 2.7 June 07

The information given in this manual is subject to change without notice. No part of thismanual may be reproduced ot transmitted in any form or by means, electronic,mechanical, photocopying or otherwise, without the written consent of Micro MedicalLimited

©2006 Micro Medical Limited, All rights reserved

Microsoft is a registered trademark and windows is a trademark of Microsoftcorporation. Other trademarks and branch names are the property of their respectiveowners.

Micro Medical LimitedQuaysideChatham MaritimeChathamKentME4 4QY

E-mail: [email protected]://www.micromedical.co.uk

Disclaimer

Micro Medical Ltd and the consensus group which designed the algorithm and theassessments underlines that these assessments should be regarded as a help. Thefinal assessment of spirometric data, and any decisions regarding diagnosis, treatmentand other interventions in a patients care remain the sole responsibility of the physicianin charge of the patient who should come to a conclusion on the basis of informationfrom various sources, of which spirometric data form only a part.

Spida 5 - Operating Manual

Read carefully before use

The software included is subject to the following license terms and conditions. Byinstalling the software onto your computer, you are signifying your acceptance of theterms of this agreement. If you do not agree in full with the terms of the agreementdescribed below, please return the installation disk intact together with all accompanyingmanuals and packaging to your supplier.

SOFTWARE LICENSE

This is a single user software license granted to you by Micro Medical Ltd. The softwareremains the property of the manufacturer and is not sold.You, as end user of the software, may use multiple copies of the software installed onmultiple computers for which it is designed, However only one Spida program can be runwith each USB dongle.Once installed on the computer, you may make back-up copies of the database for thepurpose of security. You may not copy the original CD-Rom.

SUPPORT & UPDATES

For support on the software, please contact your distributor first. UK customers. Pleasecontact Micro Medical Ltd. Tel: 01634 893500

COPYRIGHT

The enclosed software is owned by Micro Medical Ltd (and in parts by the MicrosoftCorporation) and is protected by United Kingdom or United States copyright laws andinternational treaty provisions. Neither the software nor the accompanying manuals maybe reproduced in whole or in part. You may not make changes or modifications to thelicensed software, and you may not decompile, disassemble or otherwise reverseengineer the software.

The software may not be rented or leased to others, but you may transfer your rightsunder this agreement in full provided that all copies of the software and written manualsare transferred, and that the recipient agrees to the terms of this agreement.

Software License Agreement


LIMITED WARRANTY

Micro Medical Ltd warrants that the material on which the software is supplied and theproduct documentation is free from defects in materials and workmanship under normaluse. Micro Medical Ltd warrants that the software will perform in accordance with theproduct manual for a period of 90 days from the date of receipt.During the warranty period,*Micro Medical Ltd will replace, at no charge, any magnetic media or printed manual,which proves defective in materials or workmanship on an exchange basis.*Micro Medical Ltd undertakes to replace or repair, at no charge, any software thatdoes not perform substantially in accordance with the product documentation.*If Micro Medical Ltd is unable to replace or repair the software; Micro Medical Ltd will,at its discretion and as a final remedy, replace the software with a functionally similarprogram or refund the price paid for the software license in full.

WARRANTY EXCLUSIONS

Micro Medical Ltd undertakes to ensure that the product meets the specification given inthe product literature; it does not warrant that the software supplied in this package issuitable for your specific requirements or usage. The warranty does not extend to anydamage or corruption to the supplied media or documentation subsequent to yourreceipt of the product, however caused; nor does it extend to any damage or corruptionof the program image on your computer subsequent to installation.Micro Medical Ltd does not warrant the compatibility of the software on any computerother than that described in the product specification, and takes no responsibility for anyincompatibility or problems arising from the use of other operating systems orapplication programs on your computer.MICRO MEDICAL LTD DISCLAIMS ALL OTHER WARRANTIES, EXPRESS ORIMPLIED, INCLUDING ANY WARRANTIES OF MERCHANTABILITY OR FITNESSFOR A PARTICULAR PURPOSE WITH RESPECT TO THE ENCLOSED SOFTWAREPRODUCT.MICRO MEDICAL LTD OR ITS SUPPLIERS SHALL, IN NO EVENT, BE LIABLE FORSPECIAL, CONSEQUENTIAL, OR INDIRECT DAMAGES OR LOSS ARISING FROMTHE USE OR MISUSE OF THIS PRODUCT, EVEN IF MICRO MEDICAL LTD OR ITSSUPPLIERS HAVE BEEN ADVISED OF THE POSSIBILITY OF SUCH DAMAGES. INANY CASE, THE ENTIRE LIABILITY OF MICRO MEDICAL LTD UNDER THEPROVISION OF THIS AGREEMENT SHALL BE LIMITED TO THE AMOUNT PAID BYYOU FOR THE SOFTWARE LICENSE.Should you need to request replacement or repair of the software or documentationunder the terms of this warranty or if you have any questions regarding this licenseagreement, please call Micro Medical Ltd customer service department quoting the dateof purchase and the name of the supplier.


Table of Contents

Part I Overview 2

................................................................................................................................... 21 Welcome

................................................................................................................................... 22 Setting up SPIDA

................................................................................................................................... 43 Dongle License

................................................................................................................................... 44 Contact Details

Part II How to... 4

................................................................................................................................... 41 Create a new database

................................................................................................................................... 52 Create a new patient

................................................................................................................................... 53 Delete an Examination

................................................................................................................................... 54 Delete a Patient

................................................................................................................................... 55 Edit a patient's details

................................................................................................................................... 56 Enter and Edit Examination Notes

................................................................................................................................... 67 Open a saved database

................................................................................................................................... 68 Print a Report

................................................................................................................................... 69 Run a live test

................................................................................................................................... 710 Search for a record

................................................................................................................................... 711 Sort Data

................................................................................................................................... 812 Setup the child incentive view

................................................................................................................................... 813 Upload data from a spirometer

................................................................................................................................... 814 View Trend Plot

................................................................................................................................... 815 Overlap an Examination

................................................................................................................................... 916 Configure your MicroDL

................................................................................................................................... 917 Perform a calibration check

................................................................................................................................... 1018 Create A Today List

................................................................................................................................... 1119 Use a SpiroPro with Spida

................................................................................................................................... 1520 Use a FlowScreen with Spida

Part III Views 15

................................................................................................................................... 151 All FVL View

................................................................................................................................... 162 All VTG View

................................................................................................................................... 183 All Tidal VC View

................................................................................................................................... 184 Best FVL View

................................................................................................................................... 195 Best VTG View

................................................................................................................................... 216 Best Tidal VC View

................................................................................................................................... 217 Child Incentive View

................................................................................................................................... 228 Examination Notes View

................................................................................................................................... 229 Forced Results View

I


................................................................................................................................... 2310 Summary Results

................................................................................................................................... 2411 Relaxed Results View

................................................................................................................................... 2512 Medication View

................................................................................................................................... 2513 Patient Data View

................................................................................................................................... 2614 Patient History View

................................................................................................................................... 2615 Trend View

Part IV Indices 27

................................................................................................................................... 271 Forced

.......................................................................................................................................................... 27VC (Relax Vital Capacity)

.......................................................................................................................................................... 27FEV.75 (Force Expiratory Volume in 0.75 second)

.......................................................................................................................................................... 27FEV1 (Forced Expiratory Volume in 1 second)

.......................................................................................................................................................... 27FEV3 (Forced expiratory volume in 3 seconds)

.......................................................................................................................................................... 27FEV6 (Forced expiratory volume in 6 seconds)

.......................................................................................................................................................... 27FVC (Forced Expiratory Volume)

.......................................................................................................................................................... 27PEF (Peak Expiratory Flow)

.......................................................................................................................................................... 27FEV.75/VC

.......................................................................................................................................................... 27FEV.75/FVC

.......................................................................................................................................................... 28FEV1/VC

.......................................................................................................................................................... 28FEV1% (Tiffeneau-index )

.......................................................................................................................................................... 28FEV3/VC

.......................................................................................................................................................... 28FEV3/FVC

.......................................................................................................................................................... 28FEV.75/FEV6

.......................................................................................................................................................... 28FEV1/FEV6

.......................................................................................................................................................... 28FEF25 (Forced Expiratory Flow when 25% of the FVC has been exhaled)



.......................................................................................................................................................... 30MEF25 (Maximum Expiratory Flow when 25% of the FVC remains to be exhaled)



.......................................................................................................................................................... 31FEF25-75 (Forced Expiratory Flow Between 25% and 75%)

.......................................................................................................................................................... 32MMEF (Maximal Mid Expiratory Flow)

.......................................................................................................................................................... 33FEF25-75/FVC

.......................................................................................................................................................... 33FEF50/VC

.......................................................................................................................................................... 33FEF50/FVC

.......................................................................................................................................................... 33MVV (ind) (Maximal Voluntary ventilation Indirect)

.......................................................................................................................................................... 33FIV1 (Forced Inspiratory Volume in 1 second)

.......................................................................................................................................................... 33FIVC (Forced Inspiratory Vital Capacity)

.......................................................................................................................................................... 33PIF (Peak Inspiratory Flow)

.......................................................................................................................................................... 33FIV1% (Ratio of FIV1/FIVC)

.......................................................................................................................................................... 33FIF25 (Forced Inspiratory Flow when 25% of the FIVC remains to be inhaled)



.......................................................................................................................................................... 35MIF25 (Maximum Inspiratory Flow when 25% of the FIVC has been inhaled)



.......................................................................................................................................................... 36R50 (Ratio of FEF50/FIF50)

.......................................................................................................................................................... 37MET (Mean Expiratory Time)

.......................................................................................................................................................... 37FET (Forced Expiratory Time)

.......................................................................................................................................................... 37Lung Age

.......................................................................................................................................................... 37Relaxed

......................................................................................................................................................... 37TV (Tidal Volume)

......................................................................................................................................................... 37ERV (Expiratory Reserved Volume)

......................................................................................................................................................... 37IRV (Inspiratory Reserve Volume)

......................................................................................................................................................... 37IC (Inspiratory Capacity)

II


......................................................................................................................................................... 37FRC (Functional Residual Capacity)

......................................................................................................................................................... 38RV (Reserve Volume)

......................................................................................................................................................... 38TLC (Total Lung Capacity)

......................................................................................................................................................... 38FRC/TLC

......................................................................................................................................................... 38RV/TLC

......................................................................................................................................................... 38IVC (Inspiratory Vital Capacity)

......................................................................................................................................................... 38EVC (Expiratory Vital Capacity)

................................................................................................................................... 382 Relaxed

.......................................................................................................................................................... 38EVC (Expiratory Vital Capacity)

.......................................................................................................................................................... 38IVC (Inspiratory Vital Capacity)

.......................................................................................................................................................... 38IC (Inspiratory Capacity)

.......................................................................................................................................................... 38TV (Tidal Volume)

.......................................................................................................................................................... 39ERV (Expiratory Reserved Volume)

.......................................................................................................................................................... 39IRV (Inspiratory Reserve Volume)

.......................................................................................................................................................... 39FRC (Functional Residual Capacity)

.......................................................................................................................................................... 39RV (Reserve Volume)

.......................................................................................................................................................... 39TLC (Total Lung Capacity)

.......................................................................................................................................................... 39RV/TLC

.......................................................................................................................................................... 39FRC/TLC

.......................................................................................................................................................... 39BF (Breath Frequency)

.......................................................................................................................................................... 39TI

.......................................................................................................................................................... 39TE

.......................................................................................................................................................... 39TI/T_TOTAL

.......................................................................................................................................................... 39TV/TI

.......................................................................................................................................................... 39VE

.......................................................................................................................................................... 39VC (Relax Vital Capacity)

Part V Menu Commands 40

................................................................................................................................... 401 The File Menu

.......................................................................................................................................................... 40File Menu Commands

.......................................................................................................................................................... 40New (File Menu)

.......................................................................................................................................................... 40Open (File Menu)

.......................................................................................................................................................... 40Save As... (File Menu)

.......................................................................................................................................................... 40Export to MSWord (File Menu)

.......................................................................................................................................................... 41Export to PDF (File Menu)

.......................................................................................................................................................... 41Print (File Menu)

.......................................................................................................................................................... 41Print Preview (File Menu)

.......................................................................................................................................................... 41Print Setup... (File Menu)

.......................................................................................................................................................... 41Exit (File Menu)

................................................................................................................................... 412 The View Menu

.......................................................................................................................................................... 41View Menu Commands

.......................................................................................................................................................... 42Save Settings (View Menu)

................................................................................................................................... 423 The Data Menu

.......................................................................................................................................................... 42Data Menu Commands

.......................................................................................................................................................... 42Add New Patient (Data Menu)

.......................................................................................................................................................... 43Edit Patient (Data Menu)

.......................................................................................................................................................... 45Delete Patient (Data menu)

.......................................................................................................................................................... 45Delete Examination (Data Menu)

.......................................................................................................................................................... 45Enable Delete (Data Menu)

.......................................................................................................................................................... 45Disable Delete (Data Menu)

.......................................................................................................................................................... 45Upload All (Data Menu)

.......................................................................................................................................................... 45Change Password (Data Menu)

................................................................................................................................... 454 The Setup Menu

.......................................................................................................................................................... 45Predicted Values

......................................................................................................................................................... 47Changing the Predicted Value Set

......................................................................................................................................................... 47Correction Factor

III


......................................................................................................................................................... 47Predicted Sets

......................................................................................................................................... 47Austrian

......................................................................................................................................... 48Berglund

......................................................................................................................................... 48Cotes

......................................................................................................................................... 49Crapo/HSU

......................................................................................................................................... 50Crapo/Polgar

......................................................................................................................................... 50ECCS

......................................................................................................................................... 51Eigen/Crockett

......................................................................................................................................... 52Filipinos

......................................................................................................................................... 53Gutierrez

......................................................................................................................................... 53Hedenstrom

......................................................................................................................................... 54Indonesian

......................................................................................................................................... 55Knudson

......................................................................................................................................... 56Koillinen/Viljanen

......................................................................................................................................... 57Mexican

......................................................................................................................................... 57New Zealand

......................................................................................................................................... 58NHANES III

......................................................................................................................................... 60Pereira

......................................................................................................................................... 60Roca

......................................................................................................................................... 61Taiwan

......................................................................................................................................... 61Thailand

.......................................................................................................................................................... 62Setup Menu Commands

.......................................................................................................................................................... 63Options (Setup Menu)

.......................................................................................................................................................... 64Indices (Setup Menu)

.......................................................................................................................................................... 64Report (Setup Menu)

.......................................................................................................................................................... 65Trend (Setup Menu)

.......................................................................................................................................................... 65Child Incentive (Setup Menu)

.......................................................................................................................................................... 66Device Configuration (Setup Menu)

.......................................................................................................................................................... 66Calibration Check (Setup Menu)

.......................................................................................................................................................... 68Customisation Wizard (Setup)

................................................................................................................................... 685 The Window Menu

.......................................................................................................................................................... 68Window Menu Commands

.......................................................................................................................................................... 68Cascade (Window Menu)

.......................................................................................................................................................... 68Tile (Window Menu)

.......................................................................................................................................................... 69Arrange Icons (Window Menu)

................................................................................................................................... 696 The Help Menu

.......................................................................................................................................................... 69Help Menu Commands

.......................................................................................................................................................... 69Help Topics (Help Menu)

.......................................................................................................................................................... 69Register Spida 5 (Help Menu)

.......................................................................................................................................................... 69Check for Updates (Help Menu)

.......................................................................................................................................................... 70About SPIDA 5... (Help Menu)

Part VI Other Features 71

................................................................................................................................... 711 Interpretation

................................................................................................................................... 732 Composite Curve

................................................................................................................................... 733 Include / Exclude manoeuvre

................................................................................................................................... 744 Best Criteria

................................................................................................................................... 745 ATS/ERS Criteria 2005

................................................................................................................................... 756 Forced ATS/ERS Reproducibility Criteria

................................................................................................................................... 767 Relaxed ATS/ERS Reproducibility Criteria

IV


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2


1 Overview

1.1 Welcome

Welcome to SPIDA 5 PC Software, the SPIrometry DAtabase from Micro Medical.

Spida 5 is designed to interface with all Micro Medical spirometers to perform Live spirometry, and to upload data from unitsthat support this feature. The aim is to allow a quick review of any data held in the database. Within two or three mouseclicks, the user can find the required patient data and view the Flow Volume Loops and Volume Time Graph. The mainfeatures are:

· View Flow Volume Loops and Volume Time Graph of the best manoeuvre.· View Flow Volume Loops and Volume Time Graphs of ALL the manoeuvres.· View indices of the selected manoeuvre and compare it with the best and predicted values.· View trends of major indexes of all the examinations held in the database of the selected patients.· Ability to enter and view examination notes.· Facility to add and view patient history and medication information.· Child Incentive view with the bubble gum kid, skate board race, Milkshake Kid and Wolf!All the above features can be viewed simultaneously and simply with mouse clicks.

For the best results, set the Spida 5 to your desired settings. Setting up SPIDA.

1.2 Setting up SPIDA

Step 1: Views.Spida 5 is a multi window environment with the possibility of fourteen different views in operation at any one time. You canselect which views you would like to see all the time. The rest can be opened and closed at any time you prefer. The size ofthe view can also be individually set. You will get the most benefit from Spida 5 if you set your PC display to its highestresolution setting. This way you can see more information at the same time. A screen resolution of 1240 X 1024 would bedesirable, but the best viewing can be obtained with 1600 X 1200 with 19" or 21" monitor.NOTE: You can use the Customisation Wizard to configure most options more easily…The patient database view is the main window and is present at all times. The rest of the windows can be opened from theView Menu. The patient window consists of up to four panes, and each pane consist of columns. Each pane and eachcolumn size can be changed by placing the mouse on the right hand edge of the column and dragging it to the desiredwidth.

TipAll changes must be saved by selecting Save Settings from the View Menu. The result screen always appears as it did thelast time you saved it.The types of Views are:

· Patient data – consists of patient information, date and time of examinations the patient attended, and tests perexaminations.

· Best Flow Volume – shows the best Flow Volume Loops of the Baseline and the Post 1 / Post 2 tests and thepredicted areas.

· Best Volume Time – shows the best Volume Time Graph of the Baseline and the Post 1 / Post 2 tests and thepredicted line.

· Best Tidal VC – shows the best Tidal VC Graph of the baseline, post1, post2 relaxed tidal tests. Show Relaxedmust be enabled to use this.

· All Flow Volume – shows all the Flow Volume Loops of the Baseline (in green), the Post 1 (in red) and the Post 2(in magenta) tests. The selected test is shown in Blue.

· All Volume Time – shows all the Volume Time Graphs for Baseline and the Post 1 / Post 2 tests.· All Tidal VC – shows all the tidal VC graphs for baseline, post1, post2 tests. Show Relaxed must be enabled to

use this.· Child Incentive – Displays the selected child incentive animation. The current selected animation can changed by

selecting Options -> Child Incentive. This view is only used in live exams.· Forced Results – shows the indices of the current forced test, and the comparison with the best test and the

predicted values. In the case of Post BD test, it shows the comparison with the best Baseline test.· Relaxed Results – shows the indices of the current relaxed test and a comparison with the best test and predicted

values. In the case of a post BD test it shows a comparison with the best baseline test. Show Relaxed Data mustbe enabled in setup-> Options, in order to see the relaxed results.

· Trend – shows the trend of major indexes (VC, FEV1, FVC and PEF) from all the examinations of the selectedpatients. The indexes can be selected from Options à Trend.

· History – shows the history of the patient as it was entered when the patient was added. You cannot edit theinformation in this view. To edit, you must go to Data -> Edit Patient.

· Medication – shows the Patient medication at the time of the examination. It must be added prior to performingthe examination, Via Data -> Edit Patient. It can not be added after the spirometry exam.

· Examination notes – allows you to view, enter or edit examination notes which are saved in the database.· Summary Results - Displays the Current best manoeuvres.

NOTE: To enter information with regard to Patient History and Medication, you will need to select Data on the menu bar,and choose 'Edit Patient '. You can then add the relevant information to the appropriate 'History' or 'Medication' box. Again,

3


please note that Medication must be added before a test, as it can not be added or edited afterwards.

If you are not sure which views to have on the screen, then here is a little tip.The important views are, Patient View (always present), Best FVL, All FVL, Forced Results and Examination notes. Setthem up as shown below. If you have a high resolution screen, then select the Trend View as well.

You can let Spida position the windows for you easily by closing down the unwanted windows, and then going to the MenuWindows – Tile.

Step 2: Options

Select Setup -> Options and select the options you prefer.

Step 3: Reports

Select Setup -> Reports and select the type of printed report you require. You can always change this later on when yourequire a different type of report.

Step 4: Predicted Values.

Select Setup -> Predicted Values and select the predicted values you prefer to use.

4


1.3 Dongle License

Dongle LicenseSpida 5 uses a hardware dongle license which must be inserted in to the computer each time Spida 5 is used.A dongle is a device you attached to a computer to allow you to easily move the license from one computer to another.

Dongle Missing FormIf the dongle missing form is being displayed as shown in the following image you must plug in your Spida 5 dongle and you willbe free to use the software as normal.

1.4 Contact Details

Micro Medical website:- http://www.micromedical.co.uk

Address : - QuaysideChatham MaritimeChathamKentME4 4QYEnglandUK

Telephone : - +44(0) 1634 893500Fax : - +44(0) 1634 893600

Email : - [email protected]

2 How to...

2.1 Create a new database

Spida 5 allows you to create as many databases as you choose. You may have one database for COPD patients, anotherone for asthmatic patients, etc. To create a database, select New from the File Menu, and a box will appear; either select afile or create a new one. First, select the directory where you want to place the file, and then enter the filename. You do notneed to enter the extension (.mdb), as this will be added automatically. If you select an existing file, it will be cleared andoverwritten.

The new file created will be blank. When you enter the data, you do not need to save the file. The data is directly written inthe file.

http://www.micromedical.co.uk

5


2.2 Create a new patient

To create a new patient, select Add New patient from the Data Menu. Fill up all the fields as required. Patients arecategorised by an ID field, so a unique ID is required for every patient. The ID can be a number or mixture of number andletters. If the ID you type already exists, a warning message will be displayed, prompting you to enter a different ID.

If you are using long ID – longer then nine characters, then you can use Alias ID to correspond with MicroLoop/Lab. Whenthe data is uploaded, it is matched with the ID or with the Alias ID. The Alias ID has to be unique as well, and cannot be thesame as any other ID or Alias ID. There is no need to enter an Alias ID if it is not used or if the ID field is sufficient.Date of birth, gender, height and in some cases weight fields are required for calculating predicted values. If any of thesefields are incorrectly entered, a warning message will remind you to correct it.

There are some easy ways to enter this data quickly. For date of birth, click on the down arrow on the side. A calendar willappear with today's date. Click on the year, and using the little up/down buttons, select the year. Click on the month, andpick the required month, and finally click on the date. Alternatively, you can just type in the date in the edit box.When entering the height, it is not necessary to know the measurement in the units selected. If, for example, you haveselected the height to be in centimetres, but the patient only knows his height in feet and inches, simply enter '5f9' or '5ft9',for 5 feet 9 inches and the height will be converted automatically.Similarly, in the cm setting, you can also type '62i' for 62 inches, and in the Inches setting, you can use '157c' for 157 cm,which will be converted to 62 inches.

The same applies to weight; you can enter '10s4' or '10st4' for 10 stones 4 lbs, and it will be converted into the correct unit.For the Kg setting you can enter '144p' or '144lb' for 144 lbs, whilst in the Pound setting, you can enter 65.2k for 65.2 Kgand it will be converted to 144 Lbs.

Units can be set from Setup à Options.

The Patient History cannot be more than 200 characters. This field is not meant for the whole detailed history, but enoughinformation so that a consultant or technician carrying out an examination is aware of the situation. This history is printed inthe report.

2.3 Delete an Examination

Only authorised personnel are allowed to perform delete operations. The Delete Examination option in the Data Menu isnormally disabled (greyed). To enable it, first select Enable Delete from the Data Menu, and enter a valid password. Nowselect Delete Examination and a warning will remind you that the Examination with all the relevant tests will be deleted.Check that the correct examination is being deleted and select OK.Please be careful when deleting data, as the process is irreversible.After the delete operation, remember to disable the delete functions by selecting Disable Delete from the Data menu.The default password is ADMIN when Spida 5 is first installed. Change this password as soon as possible with one of yourown choice.

2.4 Delete a Patient

Only authorised personnel are allowed to perform delete operations. The Delete Patient option in the Data Menu is normallydisabled (greyed). To enable it, first select Enable Delete from the Data Menu, and enter a valid password. Now selectDelete Patient and a warning will remind you that the patient with all the relevant examinations will be deleted. Check thatthe correct patient is being deleted and select OK.Please be careful when deleting data, as the process is irreversible.After the delete operation, remember to disable the delete functions by selecting Disable Delete from the Data menu.The default password is ADMIN when Spida 5 is first installed. Change this password as soon as possible with one of yourown choice.

2.5 Edit a patient's details

Patient details can be edited by first selecting the required patient, and then selecting Edit Patient from the Data menu.All fields can be changed as required.Refer to Add Patient for tips on how to enter the data quickly or to take advantage of the Alias ID.It is advisable to update the height and weight of patients every time they come for an examination, as this data is used forcalculating the predicted values. This is of more importance for children, as they are growing up.

2.6 Enter and Edit Examination Notes

Individual text notes can be entered for each examination.

Open the examination view (if not opened) by selecting View à Examination Notes.Click on the heading (blue bar) of the examination notes and type the required information. You can use standard Windowsediting functions, like Ctrl X to Cut, Ctrl-C to copy and Ctrl-V to paste. Select any other view and the examination notes willbe automatically saved.

To Edit the notes, place the cursor in the required position and enter new information, or delete any test. You can evenhighlight the text and press the delete key to delete the information.

6


Word wrapping is active in this view.

Since the text is saved automatically, the edit process is irreversible, so please be careful.

2.7 Open a saved database

To open a previously saved database within Spida 5, select 'File' on the Spida 5 menu bar, then click on 'Open'. Thecommand allows you to open a previously saved database from your computer or over a network. Navigate your way to thedesired database and click open. The previous database will close and the new one will appear in the data window. Thepath name of the open window is displayed in the title bar of the program.

2.8 Print a Report

Every user has a different opinion about what should be include in a printed report. Some users prefer a single page reportconsisting of indices and graphs, whilst others prefer a more comprehensive report with all the information available, like thePatient History and Examination notes. Occasionally you may wish to print the Trend Graphs. So there is no such thing as astandard report. For this reason, Spida 5 allows you to choose what you prefer in a report. The number of pages in thereport will depend on the sections you choose and the number of indices you have switched on for display.

To configure your report, select 'Setup' on the Spida 5 menu bar, then choose 'Reports'. The report is divided into thefollowing sections and you should tick the sections you would like in your report by clicking on the appropriate boxed (on-screen). The sections will be printed in the specified order.

TitlePatient DetailsPatient historyMedicationSummary of all forced testsSelected indices of the best blowInterpretationFlow Volume Loop and Volume Time GraphExamination NotesSignature LineSummary of All the ExaminationsTrend GraphsRelaxed Volume Time GraphsSummary of Relaxed TestsRelaxed Indices

Note: The Relaxed items are only available if the show relaxed option has been set in setup options.

Page size and top margins of the first page and subsequent pages can also be specified. If plain paper is used, then a topmargin of one Cm is recommended.

If you would like your report to include a business / doctor / hospital name and address, select 'Setup' from the Spida 5menu bar, then choose 'Options' and complete the 'Print Title' section.

To Print a report, select Print form the File menu.To see what the page will look like before printing, select the Print Preview command.There is an 'Export to MS Word' option in 'File' on the Spida 5 menu bar that allows you to export a report to MS Word.They contain the same information as the printed report and can be attached to a patient's medical records within anymedical system which allows a Word document to be attached.

2.9 Run a live test

To run a live test, firstly select the patient who is to be tested. If the patient does not exist in the database, create a newpatient as follows:Select 'Data ' on the Spida 5 menu bar and choose 'Add New Patient '. Make sure the relevant data is completed for thepatient, i.e. age, height, etc. This is important with regard to calculating the Predicted Values.An Examination can be performed as 'Relax VC' followed by an FVC test or just as an FVC test. If Relax VC is required, tickthe VC box on the Spida 5 toolbar.

There are two types of FVC test:1. Tidal breathing followed by Forced Expiratory and Forced Inspiratory

In this test, the patient is requested to relax first, and then (ensuring their mouth fully covers the mouthpiece) continuenormal breathing. The patient is then requested to 'inhale' as deeply as possible and then to 'exhale' all the air fromtheir lungs, as quickly as possible (forcefully); and then continue with the final inhalation of as much air as possible.The patient may end the blow abruptly, if not sufficiently encouraged.

2. Direct Forced Expiratory (with forced Inspiratory)Encourage the patient to take a deep breath and then (ensuring their mouth fully covers the mouthpiece) 'exhale' allthe air from their lungs, as quickly as possible (forcefully). The patient may end the blow abruptly, if not sufficientlyencouraged. The graphs in the FVL view and the VTG view will show the amount and flow of air as it is being exhaled.If the Inspiratory test is also required, instruct the patient to 'inhale' as soon as they feel their lungs are completely

7


empty. Inhalation should be as rapid as possible.

To begin an examination, select a current patient; then click the 'New Examination' button on the Spida 5 toolbar. 'BlowNow' will then appear on the toolbar. However, If the prompt is on (see the Spida 5 menu bar 'Setup ': 'Options ': 'Prompt')a message will be displayed on the PC screen reminding you to switch 'ON' the Spirometer in PC communication mode andensure that it is connected to the computer securely. Click 'OK' on the message and 'Blow Now' will then be displayed onthe Spida 5 toolbar.

Once 'Blow now' is displayed on the Spida 5 toolbar and the patient is ready, request them to perform a Relax VC (ifselected) or an FVC (forced expiratory manoeuvre). The FVL and the VTG will appear in the Best FVL view and theBest VTG view respectively.Once the manoeuvre has been completed, the results will appear in the results window.There will be three options on the toolbar: Accept + Next, Reject, Accept + Done.'Accept + Next' will save the test and allow you to begin a new test by displaying 'Blow Now' on the toolbar.'Reject' will discard the last manoeuvre and 'Blow Now' will be displayed on the toolbar for you to begin another test.'Accept + Done': after a VC manoeuvre (when VC must be ticked on the toolbar) will save the test and complete the VCpart of the examination, moving on automatically to 'Blow Now' for the FVC manoeuvres. 'Accept + Done': after an FVC manoeuvre will save the test and also end the examination.

NOTE: If you press 'Cancel' during a blow, you will lose the test being performed, and automatically end the currentexamination.

A maximum of 10 Baseline, five Post 1 (Post BD 1) and five Post 2 (Post BD 2) tests may be carried out.

In the Best FVL view the colours relate to the tests as follows:

BLUE - CurrentGREEN - Best BaselineRED - Best Post 1MAGENTA - Best Post 2

2.10 Search for a record

Within SPIDA 5, you can search for a patient using any of the information details present in the patient database. Thismeans you do not have to know the name of the patient, you could find him or her by their identification number (ID), theirage, or their gender. Firstly, select the column of the information you wish to search in (the records will be sorted

alphanumerically (0 to 9 and A to Z) by that field ). Next, type the name or number of the desired patient in the Searchbox in the toolbar, and click Search or press Enter on the keyboard.The corresponding record will be highlighted in blue. All the respective views will change accordingly.

2.11 Sort Data

SPIDA has the facility to sort the Patient data under any of the headings in the window - you can choose from:· Surname· First name· ID· Age· Sex· Height· Weight· Race· Factor· Occupation· Referred by

To sort data by a particular field, click on the grey column title of the appropriate column. A down arrow will appear on thetitle to mark the selected column. All data will be sorted in ascending alphanumerical order (0 to 9 and A to Z). If you clickthe column again, an up arrow will appear and the data will be sorted in descending alphanumerical order.

Searching for a record.

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2.12 Setup the child incentive view

For the first blow, the value required to reach the target is as a percentage of the predicted value (default 100%). To changethis, double click on the Child Incentive View or select Setup and Child Incentive and change the number in the top box.

For subsequent blows, the patient has to exhale a percentage of the best blow for the target to be reached (default 100%).Setting this value at 110% entices the patient to exceed their previous attempt. To change this value, double click on theChild Incentive View or select Setup and Child Incentive and change the bottom box.

The new values will be remembered by Spida 5, therefore there is no need to set it every time.

You have also a selection of child incentive screens available from the setup dialog box: a bubble gum kid, a skate boardrace, milk shake kid or Wolf

2.13 Upload data from a spirometer

When uploading data from a spirometer, firstly make sure that the unit is securely connected, switched on and that thecorrect database is open. Then click the UPLOAD button on the left of the toolbar. All the tests and new patients since thelast upload will be uploaded. This saves time as only the test not available to Spida are sent.

If you need to upload all the data because you have opened a new database or are using another PC, then selectUpload All from the Data Menu.

The data from the spirometer is then added into the current database. The data on the computer is always added to, neverreplaced. It is never deleted or overwritten.If the patient ID does not exist, a new patient is created and all the details available from the unit is filled. Use Edit Patient toadd any additional information.Warning: Make sure the target database is open before pressing the upload button or selecting Upload All.

2.14 View Trend Plot

Trend plots are a good way to view data over a period of time. Open a trend view by clicking View à Trend, if it is not yetopened. In the Patient data view, click on the patient of interest. The trend view will show the trend plot. If the patient is notin view, then either scroll up/down to find him/her or use the search feature.

You need at least two examination results to see the trend plot. You can zoom into the plot by clicking and dragging the leftmouse button over the region of interest. Clicking on the right mouse button will return to the previous scale. If you zoom inand then zoom in further, the right mouse click will take you back to the first zoom scale, and clicking again to original scale.

You can print the trend view, by first selecting the report type as 'Summary and Trend' (Setup -> Report) and then selectingFile à Print. The printed trend plot will have the same view and scale as in the Trend View, so make sure you have thecorrect portion in view before printing. This feature allows you to print the zoomed region. You can view the page layout byselecting File - > Print Preview

2.15 Overlap an Examination

You can overlap a previous Flow Volume Loop and Volume Time Graph on top of the current examination by pressing theCTRL key and left clicking the required examination. This will then be highlighted in pink. The overlapped view will appear ina darker colour then the current one, i.e. the base line will be dark green, post 1 will be dark red and post 2 will be darkmagenta. You can overlap only one examination at a time, so selecting another one will de-select the present one. Toremove the overlapping curve, just click on the examination again with the CTRL key pressed. This feature is very useful forcomparing the current examination with previous ones.

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Another good tip is that you can overlap the last examination before starting a new one. This will act as a reference on thedisplay.

2.16 Configure your MicroDL

To configure your MicroDL, simply select the patient who will be using the device, and then press Device Configuration fromthe setup menu. The patient details will appear on the top part of the dialog box. Then you will be able to enter manually thevalues that will be used as target for the patient.Alternatively, you can choose from the patient's current best and the predicted values.You can also decide which parameters to display, and the best blow selection criteria. Finally, the levels in percentage ofthe target values can be configured in Yellow level and red level.

2.17 Perform a calibration check

The calibration check facility is provided to help verify that the device is within the calibration limits (+- 3% of expected volume).We recommend that it is be performed each day before the device is used (more calibration checks may be performed in thesame day if user requires)

Performing a daily calibration check helps determine any invalid calibration results within the first day of the issue arising, aswell as providing day-to-day laboratory variability.

The calibration tool has been designed to meet the 'ATS ERS Standardisation of lung function testing' requirements as well asa quick simple method.The ATS ERS recommends that during a calibration check, the user will need to perform three syringe waveforms (Minimum of1) for three different flow rates (Between 0.5 and 12 L/Sec). The purpose of this is to help identify any invalid calibration resultsat various flow rates.

Starting the Calibration CheckThe calibration check can be found under the 'Setup' menu in Spida and then selecting 'Calibration Check'.Spida will then close and the calibration check tool will open

Please click here for a step by step guide through the calibration process, or click 'Next' at the top of this help screen

Before proceeding please verify that the device that is going to perform the calibration check, is connected to the PC via aSerial or USB cable (Depending on the device type)

Calibration SyringesTo help achieve improved results during a calibration check, Please Verify the following: -

1. The syringe used to perform the calibration check on the device, should have a accuracy of +- 15ml or +-0.5 % ofthe syringe volume (15ml for a 3 Litre syringe)

2. Syringes with adjustable or variable stops may be out of calibration if the stop is accidentally moved or reset.3. Calibration syringes should be leak tested periodically (Monthly) by blocking the air outlet and applying pressure on

the syringe handle (A dropped or damaged syringe should be leak tested before a calibration check is performed)4. The calibration syringe is kept with the spirometer (Not in direct Sunlight or any heat sources) to help maintain the

same temperature and humidity of the testing location

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2.18 Create A Today List

The MicroLab Mk8 provides a feature that enables the user to produce a list of patients from the database that the user will beperforming examinations on with in that day.

Spida also provides a feature where the user can produce the list of patients, and download the list to the MicroLab Mk8.

If the patient being downloaded from spida does not exist in the MicroLab Mk8 database, the patient will be automaticallycreated using the details held within the spida database.If the patient being added to the today list does exist on the MicroLab Mk8 database then they will be flagged as being added tothe list, however the patients details such as height, weight etc will not be updated from the spida database.

Note: - When the MicroLab Mk8 internal clock rolls over to midnight (00:00), the today list will be cleared (results will remainheld in the MicroLab database).

Adding a patient to the Today list in spida: -1. Open the database the patients you wish to add to the list exists in.2. Right click on each patient you wish to add to the today list, from the first section of the patient details window (the

patient row's background should turn yellow)3. Connect the MicroLab MK8 to the PC and verify that in spida the correct comm. port or USB is selected within

'Options'4. Verify that the MicroLab Mk8 is switched on and is in the main menu5. Select the 'Setup' menu and then 'Device Configuration'6. After clicking OK on the message prompts a new window should be displayed. In the top frame of the window should

be the today list the user just created in spida.Note: -If on clicking 'Setup', 'Device Configuration' the Microlab Mk8 clock time is +/- 5 minutes of the computer clock, amessage will prompt the user, informing them that the time needs to be adjusted.As the wrong time may be on either the Microlab Mk8 or the PC, the Microlab Mk8 time is not adjusted. This message isonly displayed the first time device configuration is selected on each spida load.

Removing a patient from the Today list created in spidaFrom 'Today List' window in spida, left click on a patient in the list (the patient row's background should turn blue) and click the'Remove' button. The patient should now be removed from the list.To remove multiple patients from the Today list left click on each of the desired patients whilst holding the 'Ctrl' button on thekeyboard.

Sending the Today List from spida to the MicroLab Mk8 unit: -1. From the 'Today List' window verify the patients to be tested are displayed in the list2. Select 'Send List To Unit' button.3. A download screen will now be displayed indicating the current status and progress of the download. Each time the

download of a patient finishes the patient row will be removed from the list in the 'Today List' window.4. Once download is complete the user will be taken back to the 'Today List' window (The list in the 'Today List' window

will now be empty)Note: - All patients in the today list once 'Send List To Unit' is clicked will be downloaded, highlighted or not.Cancelling During DownloadThe download can be stopped by clicking cancel. Once pressed the current patient being downloaded will finish beingdownloaded before cancelling the process. The user will be taken back to the 'Today list' window. Any patients remainingin the list are patients that were not downloaded.The user the has the option to exit the today list, remove patients from the today list or continue downloading theremaining patient to the MicroLab Mk8

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2.19 Use a SpiroPro with Spida

Spida 5 is compatible with the SpiroPro device. (A product of JAEGER-TOENNIES, a subsidiary of VIASYS Healthcare).When the user receives a newly purchased SpiroPro unit, it has to be configured to communicate with Spida. Once this is donethe user can perform Live spirometry, as well as Upload saved data from the SpiroPro's Database.The user is also given the ability to change Time and date on the SpiroPro via spida

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Configuring the SpiroPro for the first timeTo be able to perform live testing on spida using the SpiroPro device, the unit first needs to be configured. This configurationonly needs to be performed for the first time you use the unit.

1. Switch the SpiroPro on so that it is displaying the main screen2. Press the Settings button (bottom right of the screen)

3. Press the Settings button (top right of the screen)

4. Press the Settings button (bottom left of the screen)

5. Press the up arrow button until "Online Display" is highlighted

6. Press the scroll button at the bottom of the screen until the "Online Display" has "Yes" selected

7. Press the OK button at the bottom right of the screen

8. Press the root button at the bottom right of the screen to return you to the main menu

Performing a Live TestTo perform a live test, first make sure that the SpiroPro is switched on so that it displays the main menu, and the serial cable isconnected to the PC.

1. In Spida select the patient you wish to perform a test on, from the 'Patient Data' Window

2. Select the 'New Examination' button from the menu bar at the top of the screen (Check the VC check box if you wish toperform a relaxed Vital Capacity), or select the Relaxed or Forced command buttons if you wish to continue post testing

3. A message box will then appear, asking you to put the SpiroPro into the correct test module. The SpiroPro will then beepand display the PC Communication screen.

4. Once the PC Communication screen has disappeared, and the user has put the SpiroPro into the correct test module, theSpida message box will change, indicating that the unit has been found and is ready for testing

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5. Press the OK button on the SpiroPro screen

6. Introduce the Patient to the SpiroPro and perform the required test maneuver7. Once the Patient has finished performing the maneuver, press the OK button on the unit to end the test

8. The Results screen is now displayed on the unit, press the root button so confirm the test and send the results to Spida

Note: - Once a test has been performed, the user can select either 'Accept + Next', 'Accept + Done' or 'Reject' from Spida, If'Accept + Next' or 'Reject' is selected the unit will display the PC Communication screen, and the user will need to put theSpiroPro back into the correct test module before being able to perform another effort, If the user chose 'Accept+Done'Spida will exit testing saving the results.

Selecting the correct test moduleBefore the user can perform a live test the user has to put the unit into the correct test module (The same as that being

performed by spida).1. First from the units Main Menu select the Test button icon

2. Select the desired test button (Relaxed or Forced)

3. If you selected Forced, press the 'Post Button' (Even if doing a Baseline test), else if you selected Relaxed then skip thisstep

Note: - If the user selects the wrong test module to that being performed by Spida (e.g Spida is performing a Relaxed VC,however the user accidentally put the unit into the forced module), and an effort is performed. The SpiroPro will sendincorrect data to spida. Please verify the SpiroPro is in the correct Module before the blow is performed.

Uploading data to SpidaThe SpiroPro is capable of uploading its database to Spida. To do this : -1. Switch the Unit On so it is in the Main Menu2. Verify the serial cable is connected to the PC3. Select either the 'Upload' button from Spida's Tool Bar, or select the 'Data' drop down menu and then 'Upload All' to

upload all of the tests held on the SpiroPro's database.

Changing Time and date on the SpiroPro via spidaThe user is also given the ability to change Time and date on the SpiroPro via spida. To do this: -1. Switch the Unit On so it is in the Main Menu2. Verify the serial cable is connected to the PC3. Select the 'Setup' drop down menu and then 'Device Configuration'.4. A window will then appear allowing the user to change the Date and time5. Once the changes have been made in the Spida window click on the 'Set Date/Time' button, else click on 'Cancel' to exit

without saving the changes.

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NOTE: - The SpiroPro can not be used with the calibration tool

www.viasyshealthcare.comwww.spiropro.com

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2.20 Use a FlowScreen with Spida

Although Spida 5 can not perform live tests with the FlowScreen device (A product of JAEGER, a subsidiary of VIASYSHealthcare), it is able to upload stored data from the unit.

To Upload Data from the FlowScreen device1. Switch the FlowScreen Device off and then back on again, so that it displays the main menu2. Verify the serial cable is connected to the PC and the Device3. Select either the 'Upload' button from Spida's Tool Bar, or select the 'Data' drop down menu and then 'Upload All' to

upload all of the tests held on the FlowScreen database.

NOTE: - The FlowScreen can not be used with the calibration tool

3 Views

3.1 All FVL View

This view shows the Flow Volume Loop of ALL the tests of the selected examination.The Baseline tests are shown in green, the Post 1 tests in red and the Post 2 tests in magenta. The selected test is in blue.The predicted region is displayed as a grey background.Excluded manoeuvres are displayed in the drug stage colour as dashed curves.

Best FVL View

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The Flow Volume curve indicates the position of FEV1 using a short vertical line (circled below in red).

3.2 All VTG View

This view shows the Volume Time Graphs of all the test of the selected forced examination.

The Baseline tests are shown in green, the Post 1 graphs are in red, and Post 2 graphs are in magenta. The selected test isin blue. The predicted line is shown in grey. Excluded Manoeuvres are displayed in the drug stage colour as dashed curves

Best VTG View.

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Time Zero PositionSpida recalculates the Extrapolated Volume (EV) on manoeuvres with a 'Slow Start' blow quality, and repositions thewaveform to the new time zero position.In doing this it will cause all of the Volume/Time graphs expiratory curves to start at the same time zero, which helps theuser identify and compare the time dependant indices such as FEV1, FEV3, FEV6 Etc

The diagram above demonstrated how spida calculates the patients Extrapolated Volumeon the early part of the waveform, through the steepest part of the curve and determine the new time zero.

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3.3 All Tidal VC View

This view shows the volume time trace for ALL tidal tests of the selected examination.The Baseline tests are shown in green, the Post 1 tests in red and the Post 2 tests in magenta. Theselected test is in blue.

To enable this view the Show Relaxed option must be selected in the Setup Options.

Best Tidal VC View

3.4 Best FVL View

This window shows the best Baseline Test (in green), the best Post 1 test (in red), and the best Post 2 test (in magenta).The grey area/line is the predicted region/line.If a live examination is being performed, the FVL will be drawn in this window, superimposed onto the best flow volumeloops for reference. The current live test will be coloured blue.

If there are other examinations available, you can overlap its flow volume loop with the current one, by pressing the CTRLkey and left clicking the required examination. This will then be highlighted in pink. The overlapped view will appear in adarker colour then the current one, i.e. the base line will be dark green, post 1 will be dark red and post 2 will be darkmagenta. You can overlap only one examination at a time, so selecting another one will de-select the present one. Toremove the overlapping curve, just click on the examination again with the CTRL key pressed. This feature is very useful forcomparing the current examination with previous ones.


All FVL View.

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The Flow Volume curve indicates the position of FEV1 using a short vertical line (circled below in red).

3.5 Best VTG View

This view shows the best Baseline Test (in green), the best Post 1 test (in red), and the best Post 2 test (in magenta). Thepredicted line is in grey.If a live examination is being performed, the Volume Time Graph will be drawn in this window, superimposed onto the bestVTGs for reference. The live test will be coloured blue. In the case of Post test, the best Baseline test is also displayed ingreen.

All VTG View

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Time Zero PositionSpida recalculates the Extrapolated Volume (EV) on maneuvers with a 'Slow Start' blow quality, and repositions thewaveform to the new time zero position.In doing this it will cause all of the Volume/Time graphs expiratory curves to start at the same time zero, which helps theuser identify and compare the time dependant indices such as FEV1, FEV3, FEV6 Et.

The diagram above demonstrated how Spida calculates the patients Extrapolated Volumeon the early part of the waveform, through the steepest part of the curve and determine the new time zero.

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3.6 Best Tidal VC View

This window shows the best relaxed tidal Baseline Test (in green), the best Post 1 test (in red), and the best Post 2 test (inmagenta).If a live tidal examination is being performed, the tidal trace will be drawn in this window, superimposed onto the best effortso far for reference. The current live test will be coloured blue.

If there are other examinations available, you can overlap its flow volume loop with the current one, by pressing the CTRLkey and left clicking the required examination. This will then be highlighted in pink. The overlapped view will appear in adarker colour then the current one, i.e. the base line will be dark green, post 1 will be dark red and post 2 will be darkmagenta. You can overlap only one examination at a time, so selecting another one will de-select the present one. Toremove the overlapping curve, just click on the examination again with the CTRL key pressed. This feature is very useful forcomparing the current examination with previous ones.


To enable this view the Show Relaxed option must be selected in the Setup Options.

All Tidal VC View.

3.7 Child Incentive View

The Child incentive view is designed to give visual feedback as to how much air has been exhaled.

The "Bubble Gum Kid" blows a bubble whose size is proportional to the amount of air exhaled. If the FVC value reaches aspecified value, the bubble bursts.The skate board race allows the patient to compete against the computer, and to pass the finish line if the target is reached.The milk shake kid blows bubbles into the milk shake and overflow's when the target is reached.The Wolf blows out and if the target is reached, will blow the house away.

See Setting up the Child Incentive window for details on how to change the value of when bubble burst, and the view youwish to use.

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3.8 Examination Notes View

This view shows the examination notes of the selected examination. Every examination can have its own diagnostic notes.The notes can be entered or edited by simply placing the cursor on the notes view and typing the required notes. All thenormal edit functions, for example, cut and paste are available. The view can be set to any size required, and the words willwrap round to fit the window size.

The data will be saved automatically when the focus changes from this view to another view, or Spida 5 is terminated.

3.9 Forced Results View

This view is in three parts.The top part displays the Quality Check of the manoeuvre. If the manoeuvre is correctly performed, it displays 'Good Blow'otherwise it displays a warning indicating where a blow could be improved. If more then one blow has been preformed in thisexamination, then it displays the variance of this blow with respect to the current best blow. If the variance is above 100%and this blow is accepted, then this becomes the best blow. The variance is calculated using the best criteria as selected inthe Options dialog box. The default is FEV1+ FVC.

The following warnings could be displayed:

Slow StartLow VolumeShort BlowPossible CoughAbrupt EndPoor Effort

The second part displays the selected indices of the current test.The Indices can be selected from Setup à Indices. Any number of indices can be selected, but care should be taken as thesame selected indices will be printed in the report. Un-required indices may unnecessarily increase the size of the report.The following indices can be viewed:VC - Relax Vital Capacity.FEV.75 – Force Expiratory Volume in 0.75 second.FEV1 - Forced Expiratory Volume in 1 second.FEV3 – Forced Expiratory Volume in 3 seconds.FEV6 – Forced Expiratory Volume in 6 seconds.FVC- Forced Expiratory Vital Capacity.PEF- Peak Expiratory Flow.FEV.75/VC – Ratio of FEV.75/VC.FEV1/VC – Tiffeneau Index. Ratio of FEV1/VC. Only available if VC test is performed.

FEV1% – Tiffeneau Index. Ratio of FEV1/FVC. Uses VC if available and selected. Options.FEV3/VC – Similar to Tiffeneau Index, but uses FEV3 instead of FEV1.FEV3/FVC - Similar to Tiffeneau Index, but uses FEV3 instead of FEV1. Uses VC if available and selected.FEV.75/FEV6 – Ratio of FEV.75/FEV6.FEV1/FEV6 – Similar to Tiffeneau Index for those who use FEV6 instead of FVC.FEF75 - Forced Expiratory Flow when 75% of the FVC has been exhaledFEF50 – Forced Expiratory Flow when 50% of the FVC has been exhaledFEF25 – Forced Expiratory Flow when 25% of the FVC has been exhaledFEF25-75 – Forced Expiratory Flow Between 25% and 75%FEF25-75/FVC – Ratio of FEF25-75/FVC.FEF50/VC – Ratio of FEF50/VC.FEF50/FVC – Ratio of FEF50/FVC.MVV (ind) - Maximal Voluntary Ventilation Indirect - air expired during voluntary ventilation for one minute.FIV1 – Forced Inspiratory Volume in 1 second.FIVC – Forced Inspiratory Vital Capacity.PIF PIF - Peak Inspiratory Flow.FIV1% - Ratio of FIV1/FIVC. – Similar to Tiffeneau Index but for Inspiratory.FIF75 – Forced Inspiratory Flow when 75% of the FIVC remains to be inhaled

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FIF50 – Forced Inspiratory Flow when 50% of the FIVC remains to be inhaledFIF25 – Forced Inspiratory Flow when 25% of the FIVC remains to be inhaledR50 – Ratio of FIF50/FEF50.MET – Mean Expiratory Time.FET – Forced Expiratory Time.TV – Tidal Volume.ERV – Expiratory Reserve Volume.IRV – Inspiratory Reserve Volume.IC – Inspiratory Capacity.FRC – Functional Residual Capacity.RV – Reserve Volume.TLC – Total Lung Capacity.FRC/TLC – Ratio of FRC/TLC.RV/TLC – Ratio of RV/TLC.Lung Age – Estimated Lung Age.Dyspnoea Score.

The table shows the actual values alongside the predicted values and a comparison between the two. It also shows the bestvalue and how the current test compares to the best.If it is a Post 1 test, then the results window also displays the best Baseline test values, and shows the % change betweenthe two. For Post 2 test, there is addition of comparison with Post 1 test.

The third part displays the ATS/ERS Reproducibility criteria as well as the Interpretation (as based on algorithms publishedby Enright, ATS, NICE.)

3.10 Summary Results

The Summary Results screen Differs slightly from the forced and relaxed results views, in that it always displays the BestBase and Post1 result from the selected examination. This way the user is always given the correct up to date best results.

Unlike the relaxed and forced results windows, if a test is selected from the Patient data view that is not the best, thesummary Results window still displays the same information, where as the forced and relaxed view will update to display theselected test.

The Indices displayed in this view can be selected from 'Setup', 'Indices' menu option. Any number of indices can be

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selected, but care should be taken as the same selected indices will be printed in the report. Un-required indices mayunnecessarily increase the size of the report. (Please see 'Forced Results' View for a list of available Indices)

The table shows the Best Base and Post1 values, alongside the predicted values and a comparison between the two. It alsoshows the percentage change between the base and the pos1 test.

It also provides a blue information box regarding Predicted Values. It gives information on the current predicted set in useaswell as give the height or age used in the predicted values equations if the patient height or age entered fell outside of thesets age or height range

3.11 Relaxed Results View

This view is in three parts.The top part displays the %variance between the selected relaxed blow, and the best relaxed blow (blank if the best blow isselected).

The second part displays the selected indices of the selected test.The Indices can be selected from Setup à Indices (Relaxed Tab). Any number of indices can be selected, but care should betaken as the same selected indices will be printed in the report and exported to MS Word. Un-required indices mayunnecessarily increase the size of the report.

The following indices can be viewed:EVC – Slow expiratory VC.IVC – Slow Inspiratory VC.IC – Inspired Capacity.TV – Tidal Volume (also VT).ERV – Expired reserve volume.IRV- Inspired reserve volume.FRC- Functional Residual Capacity.RV – Reserve volume.TLC – Total lung capacity.RV/TLC – Ratio of RV to TLC.FRC/TLC – Ratio of FRC to TLC.BF – Breath Frequency (also FR)TI – Time inspired (tidal).TE – Time expired (tidal).TI/T_TOTAL - Time inspired / Time in total (tidal).TV/TI – Ratio of TV to TI.VE – Minute Ventilation - volume of air expired in 1min (TV * BF).VC – Relaxed vital capacity.

The table shows the actual values alongside the predicted values (where available) and a comparison between the two. It alsoshows the best value and how the current test compares to the best.

If it is a Post 1 test, then the results window also displays the best Baseline test values, and shows the % change between thetwo. For Post 2 test, there is addition of comparison with Post 1 test.

The third part displays the ATS/ERS Reproducibility criteria

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3.12 Medication View

This view shows the patients medication at the time of the examination.

3.13 Patient Data View

This view gives access to the entire SPIDA 5 database instantaneously. The Data view is split into 3 or 4 panes. The lefthand pane contains the patient details and information. The data can be sorted by any one of these fields (See Sorting theData). To select a patient, click on the name of the patient. The selected row will be coloured blue to show that it has beenselected.

It is not necessary to view all the fields. A pane can be truncated after the main fields i.e. Surname, First name, ID, and age.All the column widths can be sized separately by clicking and dragging on the right margin of the column. The PatientHistory and the Medication can be viewed on its own separate view.The middle pane contains information about all the examinations performed on the selected patient, the date and time of theexamination, and how many tests (baseline, Post 1 and Post 2) were performed (max for each is fifteen). The height andweight of the patient at each examination is also recorded, so the predicted values can be calculated accordingly.

The right hand pane contains the information about the tests within the selected examination and can be split horizontally intwo providing a fourth pane. FEV1, FVC and PEF details are available immediately in the top half and EVC, IVC, VC in thebottom. To get an in depth review of the results for a particular test click on the relevant row and they will appear in theforced Results view or relaxed results view. The FVL and the VTG will appear in the relevant views with the selected testhighlighted in blue.

Tests are automatically excluded from the forced results pane if they do not have a blow quality of either 'Good Blow' or'Short Blow'. Excluded results are Highlighted in light blue.Excluded exams can not be selected unless the user Re-Included the test to the examination.To Include or exclude manoeuvres to the examination simply right click on the effort, and select Include or exclude from thedrop down menu.Note: - A minimum of one test must be included.

Use the setup options to enable the fourth pane and see the relaxed results.

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3.14 Patient History View

This view shows the patient history as specified in the patient database. The history can be edited by selecting Edit Patientfrom the Data Menu. All the other patient data can be viewed in Patient Data View.

3.15 Trend View

This view shows the graph of the parameter values over a period of time. It is very useful to see how the patient isprogressing. Four major parameters in any combinations can be selected. See Setup à Parameters.

Trends can only be viewed on best baseline test. At present there is no trend facility on Post BD data.

The y-axis units for VC, FEV1 and FVC is Litres whilst for PEF it is L/S. If the PEF is selected with any other parameter,then the y-axis will not have any units, but just the numbers. Note: PEF is always in L/S.

You can zoom into the graph by clicking and dragging the left mouse button over the required region. The graph will showthe area specified. Clicking the right mouse button will return back to the original area.

Double clicking on a parameter point will select that examination, and all the respective views will change accordingly.

The format of date and time on the graph is as per your PC settings. Try to set this as the shortest date and time so as tonot cluster the x-axis. For example, set your date to display as dd/mm/yy rather then dd/mm/yyyy. For time, set as hh:mminstead of hh:mm:ss. The format of date and time can be set from the control panel.

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4 Indices

4.1 Forced

4.1.1 VC (Relax Vital Capacity)

The change in lung volume from the beginning of a relax expiratory manoeuvre when the lungs are completely full, to theend when they contain only the residual volume.

Note: This value will be taken for FEV1% calculation if available and the desired setting set. See Setup -> Options.Note2: It is defined in Spida as whichever value available between EVC and IVC.

Click here for a graphical explanation.

4.1.2 FEV.75 (Force Expiratory Volume in 0.75 second)

The volume exhaled during the first 0.75 second of a forced expiratory manoeuvre. FEV1 is most commonly used, but somephysician prefer 0.75 seconds instead of one second.

Click here for a graphical explanation

4.1.3 FEV1 (Forced Expiratory Volume in 1 second)

The volume exhaled during the first second of a forced expiratory manoeuvre.


4.1.4 FEV3 (Forced expiratory volume in 3 seconds)

The volume exhaled during the first three seconds of a forced expiratory manoeuvre. This index is sometimes used byphysicians who thinks FEV1 is too short, especially for COPD patients.


4.1.5 FEV6 (Forced expiratory volume in 6 seconds)

The volume exhaled during the first six seconds of a forced expiratory manoeuvre. Not many patients can perform an FVCmanoeuvre correctly without the assistance of a trained nurse, so FEV6 is sometimes preferred by some physicians.


4.1.6 FVC (Forced Expiratory Volume)

The change in lung volume from the beginning of a forced expiratory manoeuvre when the lungs are completely full, to theend when they contain only the residual volume.


4.1.7 PEF (Peak Expiratory Flow)

Maximum flow generated during a forced expiratory manoeuvre starting when the lungs are at full capacity.


4.1.8 FEV.75/VC

This ratio is similar to the Tiffeneau-index, but based on FEV.75 . This index will only be available if a VC test is performed.

4.1.9 FEV.75/FVC

This ratio is similar to the Tiffeneau-index, but based on FEV.75. If the setting 'use VC if available' is set in Setup à Options,then it will use VC if available.

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4.1.10 FEV1/VC

This is the true Tiffeneau Index. This index is only available if a VC test is performed. See FEV1%.

4.1.11 FEV1% (Tiffeneau-index )

The Tiffeneau index is the ratio of FEV1%/VC if Relax VC is available, or FEV1/FVC. In Spida 5, you can select to use

Relax VC (if available) or always use FVC. Options.

This is a standard index for assessing and quantifying airflow limitation.

4.1.12 FEV3/VC

Ratio of FEV3/VC. This is for users who use FEV3 instead of FEV1.

4.1.13 FEV3/FVC

Ratio of FEV3/FVC. . This is for users who use FEV3 instead of FEV1. If the setting 'use VC if available' is set in Setup àOptions, then it will use VC if available.

4.1.14 FEV.75/FEV6

Similar to the Tiffeneau-index, but uses FEV.75 in place of FEV1 and FEV6 instead of VC. Suitable for those who use thesetwo values.

4.1.15 FEV1/FEV6

Similar to the Tiffeneau-index, but uses FEV6 instead of FVC. Suitable for those who uses FEV6 instead of FVC or VC.

4.1.16 FEF25 (Forced Expiratory Flow when 25% of the FVC has been exhaled)

Flow in Litres per second when 25% of the total volume that has already been exhaled.

This is similar to MEF75 (Maximum Expiratory Flow when 75% of the FVC remains to be exhaled)





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4.1.19 MEF25 (Maximum Expiratory Flow when 25% of the FVC remains to beexhaled)

Flow in Litres per second when 25% of the total volume remains to be exhaled

This is similar to FEF75 (Forced Expiratory Flow when 75% of the FVC has already been exhaled)





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4.1.22 FEF25-75 (Forced Expiratory Flow Between 25% and 75%)

The FEF25-75 is the average expiratory flow over the middle half of the FVC.FEF25-75 = ½FVC/X(where X = time required to exhale the middle half of the FVC).

The best FEF25-75 result displayed in the Forced Results window, Summary Results window and on the printed reports isthe effort with the biggest FEV1 + FVC from all acceptable blows ('Good Blow' or 'Short Blow').If the patient has not produced any acceptable blows, then the effort with the biggest FEV1 + FVC from the included testsshall be used

If the composite curve is not set, then the current set best FEF25-75 result shall be used.

This is also referred as MMEF (MMEF (Maximal Mid Expiratory Flow).

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4.1.23 MMEF (Maximal Mid Expiratory Flow)

The MMEF is the average expiratory flow over the middle half of the FVC.MMEF = ½FVC/X(where X = time required to exhale the middle half of the FVC).

The best MMEF result displayed in the Forced Results window, Summary Results window and on the printed reports is theeffort with the biggest FEV1 + FVC from all acceptable blows ('Good Blow' or 'Short Blow').If the patient has not produced any acceptable blows, then the effort with the biggest FEV1 + FVC from the included testsshall be used

If the composite curve is not set, then the current set best FEF25-75 result shall be used.

This is also referred as FEF25-75 (Forced Expiratory Flow Between 25% and 75%).

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4.1.24 FEF25-75/FVC

This is the ratio of FEF25-75 to FVC.

4.1.25 FEF50/VC

Ratio of FEF50/VC. This index is used by some physicians in France, but there is no additional information available. Theunit of this is 'per Second'.

4.1.26 FEF50/FVC

Ratio of FEF50/FVC. This index is used by some physicians in France, but there is no additional information available. Theunit of this is 'per Second'. If the setting 'use VC if available' is set in Setup à Options, then it will use VC if available.

4.1.27 MVV (ind) (Maximal Voluntary ventilation Indirect)

MVV is the Maximal Volume of air expired during voluntary ventilation for one minute. Since this test is not done, thereading given here is an indirect reading based on the FEV1 value. It is given as 37.5 X FEV1 for all predicted valuesettings, except Austria, where it is 30 X FEV1.

4.1.28 FIV1 (Forced Inspiratory Volume in 1 second)

The volume inhaled during the first second of a forced Inspiratory manoeuvre. Normally this manoeuvre is done after theForced Expiratory manoeuvre.

4.1.29 FIVC (Forced Inspiratory Vital Capacity)

Total volume inhaled during the forced Inspiratory manoeuvre.


4.1.30 PIF (Peak Inspiratory Flow)

Maximum flow generated during an Inspiratory manoeuvre started when the lungs are at residual volume


4.1.31 FIV1% (Ratio of FIV1/FIVC)

This is similar to the Tiffeneau index, but for Inspiratory manoeuvre.

4.1.32 FIF25 (Forced Inspiratory Flow when 25% of the FIVC remains to be inhaled)

Flow in Litres per second when 25% of the total volume remains to be inhaled.

This is similar to MIF75 (Maximum Inspiratory Flow when 75% of the FVC has already been inhaled)

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4.1.35 MIF25 (Maximum Inspiratory Flow when 25% of the FIVC has been inhaled)

Flow in Litres per second when 25% of the total volume has already been inhaled.

This is similar to FIF75 (Forced Inspiratory Flow when 75% of the FVC remains to be inhaled)




This is similar to FIF50 (Forced Inspiratory Flow when 50% of the FVC remains to be inhaled)

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This is similar to FIF25 (Forced Inspiratory Flow when 25% of the FVC remains to be inhaled.)


4.1.38 R50 (Ratio of FEF50/FIF50)

Percentage ratio of FEF50 / FIF50

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4.1.39 MET (Mean Expiratory Time)

Time taken in forced expiratory manoeuvre to exhale the lung capacity from 75% to 25%.

4.1.40 FET (Forced Expiratory Time)

Time taken to perform the forced expiratory manoeuvre.

4.1.41 Lung Age

Estimated Lung Age of the patient as specified by Morris and Temple.

This index was originally created as a motivation for smoking cessation. The estimated lung age can be passed to a patientto inform them of 'how old their lungs are performing'. It is based on height and the FEV1 value of the patient.

James F Morris and William Temple. Spirometric "Lung Age" Estimation for Motivating Smoking Cessation. PreventiveMedicine 14, 655 – 662 (1985).

4.1.42 Relaxed

Some Device such as the MicroLab Mk6 and MicroLoop Mk6 measure some relaxed indices from aforced maneuver and will therefore display the relaxed indices in a forced result screen, and will onlydisplay the VC (EVC or IVC) as relaxed.

Click here for a graphical explanation of some of the Relaxed Indices.

4.1.42.1 TV (Tidal Volume)

Volume of air expired during tidal breathing.


4.1.42.2 ERV (Expiratory Reserved Volume)

Additional volume of air exhaled (below the tidal breathing) during forced expiratory manoeuvre.


4.1.42.3 IRV (Inspiratory Reserve Volume)

Additional volume of air inhaled (over the tidal volume) during forced Inspiratory manoeuvre.


4.1.42.4 IC (Inspiratory Capacity)

Volume of air inhaled before the forced expiratory manoeuvre. This is from the end of tidal breathing.

Relaxed ICThe IC value listed as best in the relaxed results window and on the printed report, is the average IC value from all tidalrelaxed efforts performed for the selected drug stage, wether 'Show Composite Curve' is enabled or not'.

Forced ICThe forced IC value listed in the forced window should only be given if performing or uploading a test from a MicroLab orMicroLoop Mk6.

The IC value listed in the forced results window (For Older Devices), will also average the IC value when 'Show Compositecurve' is enabled, but only from the Acceptable blows. (Acceptable manoeuvres are blow which resulted in a 'Good Blow' or'Short Blow' quality check). If composite is unchecked it will give the IC value from the best effort.

Reference : - "ATS/ERS Task Force: Standardisation Of Lung Volume Testing", Eur Respir J 2005 26:319-338.


4.1.42.5 FRC (Functional Residual Capacity)

Value in Litres entered in the patient details. FRC is measured by some other equipment. Entering this value allows somemore indices to be calculated.


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4.1.42.6 RV (Reserve Volume)

Possible amount of air remaining inside the lungs after forced expiration.


4.1.42.7 TLC (Total Lung Capacity)

Maximum volume of air inside the lungs at maximum inspiration.


4.1.42.8 FRC/TLC

Ratio of Functional Residual Capacity/ Total Lung Capacity.

4.1.42.9 RV/TLC

Ratio of Reserve Volume/Total Lung Capacity.

4.1.42.10 IVC (Inspiratory Vital Capacity)

The volume change of the lung between a maximal expiration to residual volume and a inspiration to full capacity.


4.1.42.11 EVC (Expiratory Vital Capacity)



4.2 Relaxed

4.2.1 EVC (Expiratory Vital Capacity)



4.2.2 IVC (Inspiratory Vital Capacity)



4.2.3 IC (Inspiratory Capacity)

Volume of air inhaled before the forced expiratory manoeuvre. This is from the end of tidal breathing.

Relaxed ICThe IC value listed as best in the relaxed results window and on the printed report, is the average IC value from all tidalrelaxed efforts performed for the selected drug stage, wether 'Show Composite Curve' is enabled or not'.

Forced ICThe forced IC value listed in the forced window should only be given if performing or uploading a test from a MicroLab orMicroLoop Mk6.

The IC value listed in the forced results window (For Older Devices), will also average the IC value when 'Show Compositecurve' is enabled, but only from the Acceptable blows. (Acceptable manoeuvres are blow which resulted in a 'Good Blow' or'Short Blow' quality check). If composite is unchecked it will give the IC value from the best effort.



4.2.4 TV (Tidal Volume)

Volume of air expired during tidal breathing.


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4.2.5 ERV (Expiratory Reserved Volume)

Additional volume of air exhaled (below the tidal breathing) during forced expiratory manoeuvre.


4.2.6 IRV (Inspiratory Reserve Volume)

Additional volume of air inhaled (over the tidal volume) during forced Inspiratory manoeuvre.


4.2.7 FRC (Functional Residual Capacity)

Value in Litres entered in the patient details. FRC is measured by some other equipment. Entering this value allows somemore indices to be calculated.


4.2.8 RV (Reserve Volume)

Possible amount of air remaining inside the lungs after forced expiration.


4.2.9 TLC (Total Lung Capacity)

Maximum volume of air inside the lungs at maximum inspiration.


4.2.10 RV/TLC

Ratio of Reserve Volume/Total Lung Capacity.

4.2.11 FRC/TLC

Ratio of Functional Residual Capacity/ Total Lung Capacity.

4.2.12 BF (Breath Frequency)

Breath frequency – also respiratory frequency and is the number of single breaths achieved (or would have been achieved)in one minute during normal tidal breathing.

4.2.13 TI

The time taken for the Inspiratory part of the tidal volume loop for a single breath.

4.2.14 TE

The time taken for the expiratory part of the tidal volume loop for a single breath.

4.2.15 TI/T_TOTAL

The Inspiratory time involved in a single tidal breath divided by the total time for the breath. Also TI / (TI + TE).

4.2.16 TV/TI

Ratio of TV/TI

4.2.17 VE

Minute Ventilation – this is the volume of air expired in 1 minute and is equal to tidal volume (TV) * respiratory frequency(BF).

4.2.18 VC (Relax Vital Capacity)

The change in lung volume from the beginning of a relax expiratory manoeuvre when the lungs are completely full, to theend when they contain only the residual volume.

Note: This value will be taken for FEV1% calculation if available and the desired setting set. See Setup -> Options.

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Note2: It is defined in Spida as whichever value available between EVC and IVC.


5 Menu Commands

5.1 The File Menu

5.1.1 File Menu Commands

The File Menu offers the following commands:-

New To open a new database. Select a name for your database within extension mdb. You can have differentdatabase for different group of patients, for example, Asthmatic, COPD etc.

Open To select a database which already exist.

Save As To save this database with a new name. This is the same as making a copy of the current database.

Export to Word To export all the currently opened windows to a Microsoft Word document.

Print To print a report. A report can be of three different type. See Setup -> Report.

Print Preview To view the report on the screen before printing it out.

Print Setup To select the printer and paper size.

Exit To exit from Spida 5.

5.1.2 New (File Menu)

This creates a new blank database, the path and name of which can be specified.

5.1.3 Open (File Menu)

This opens an already existing database from your PC or network.

5.1.4 Save As... (File Menu)

This command copies the open database and renames it to a name of your choice. Any changes thereafter are made to thenew database, and not the old one.

5.1.5 Export to MSWord (File Menu)

If you click on this menu item, the currently selected options in the report setup will be exported to a Microsoft Worddocument.MS Word will need to be installed on the machine in order to gain access to this function.Compatible versions of MS Word supported: Word97, Word2000 and Word XP.Note that if you use Word97, you might get overlapped pictures, in which case you will have to re-position them beforesaving your document.

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5.1.6 Export to PDF (File Menu)

If you click on this menu item, the currently selected options in the report setup will be exported to a PDF document.Acrobat Reader will need to be installed on the machine in order to gain access to this function.It is recommended that you have the latest version of Acrobat Reader installed, which is free to download off of the internet.

If you are unable or do not have access to the internet, a copy of Acrobat Reader is available on the Spida Installation CD.

5.1.7 Print (File Menu)

This command prints a report of the selected examination.To change the printer used, click Print Setup … from the File Menu. To Set the Hospital Name and address used on thereport, change the relevant fields in the Options dialogue box.

5.1.8 Print Preview (File Menu)

This command allows you to view how the report would look if it were printed. If you are satisfied with the result, click theprint button to send it to the printer. (See Print Setup for details about selecting a printer) This feature allow you to zoom inand out to view particular areas of the document more closely.

5.1.9 Print Setup... (File Menu)

This command allows the user to change the printer used when a report is printed.Select the desired printer from the drop down box and click OK.If you are unsure as to which printer to use, contact your systems administrator.

5.1.10 Exit (File Menu)

Running this command will close the application. The open database will be saved.

5.2 The View Menu

5.2.1 View Menu Commands

Listed in the view menu are all the windows available. To make a window appear, click on it in the view menu. To remove itfrom your screen, click the cross in the top right corner of the screen.Only one instance of each window is allowed to be open.

The View Menu offers the following commands:-

List of views: Clicking on any view will open the view window (if not opened). To close the window, click on the crosssituated on the top right hand side of the window. To use the relaxed views the Show Relaxed option mustbe selected in the Setup Options

Copy View Selecting the menu option will copy the contents of the currently selected window within spida to thewindows clipboard

Save Settings Saves the settings of all the windows, their positions and size as default. Even the Patient Data Viewwindow panes and columns position and sizes are saved. Whenever you start Spida 5, it will start withthis default settings.

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5.2.2 Save Settings (View Menu)

Use this command to save the current windows that are opened, its position and its size as default. In Patient Data View, italso saves the size and the position of the three window panes and its columns. When you next run SPIDA 5, the last savedwindow arrangement will be restored.

Setting up SPIDA.

5.3 The Data Menu

5.3.1 Data Menu Commands

The Data menu offers the following commands:-

Add New Patient Add a new patient to the database

Edit Patient Edit a currently selected patient. All the fields can be edited except the ID

Delete Patient Delete the patient and all its examinations. This option is only available to users who are authorised todelete data. To enable the authorization, see Enable Delete.

Delete Examination Delete a selected examination. This option is only available to users who are authorised to deletedata. To enable the authorization, see Enable Delete.

Enable Delete Select this to enter a password to allow Delete Patient and Delete Examination to be enabled. Thisensures that only authorized person are allowed to delete data.

Disable Delete Once the delete functions are enabled, you can disable them so that data cannot be deleted by un-authorised persons.

Upload All Upload ALL the data from the spirometer to Spida 5. The UPLOAD button only uploads the datathat has been added since the last upload, whilst this selection will upload all the data, eventhough they already exist in Spida 5.

Change Password Allows you to change the password. The default password is ADMIN. It is important to change thispassword to your own password so that only authorized people can enable the delete functions.Select a password that you can remember , but it should not be very simple (like your name) sothat unauthorised persons can gain access to it. If it helps, note it down in a safe place. However,if you forget the password, get in touch with your dealer, who may be able to help you out.

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5.3.2 Add New Patient (Data Menu)

This command allows you to add a new patient to the open database.For the predicted values to be correct, the Date of Birth, gender and height should be filled in, although it is preferable to fillin everything.ID must be filled in with some value. The maximum number of characters allowed is 20. ID must be unique for every patient;otherwise error message will be displayed.If your ID is longer then nine characters, you can use alias ID to correspond with MicroLoop, MicroLab or MicroDL ID's.When the data is uploaded from these spirometer's, it will try to match with the Patient ID or with Alias ID. This allows youto have long ID's in Spida 5, yet the upload will load the data to the correct patient. Alias ID cannot be the same as anyother ID or any other Alias ID.Height: must be between 20cm and 300cm.Origin (Ethnic Origin) is used for adjusting the predicted values where Ethnicity is not defined. For most predicted values,origin other then Caucasians will be considered as Non-Caucasian. A correction factor of 12% for ages 6- 17 and 15% forages 18+ will apply for indices FEV1 and FVC for non-Caucasians. If other correction factors are required, then use thefactor field.A factor is used for changing the predicted value of FEV1 and FVC by the amount specified. For example, if the predictedvalue for FEV1 is 3.0L and factor set for 10%, then the predicted value will be 3.0L – 0.01 X 3.0L = 2.7L. The factor has no

effect on Crapo predicted values. Predicted Values.

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Note: All the fields must have valid values, otherwise an error message will be displayed.You can enter height as '5f4' or '5ft4' for 5 feet 4 inches, and it will be converted into the correct units. If your setting is inCm., you can also enter the height as '64i' for 64 inches or in the Inches setting, you can enter as '163c' for 163 Cm.You can enter weight as '10s5' or '10st5' for 10 stones 5 pounds, or as 145p (145 pounds), or 65.6k (65.6 Kg).

Click the down arrow next to the Date of Birth box to reveal the date picker below.

5.3.3 Edit Patient (Data Menu)

This command allows the user to change the details of the selected patient.Complete the necessary changes and press OK. If you make a mistake, press the Cancel button to close the dialogue boxwithout saving the changes made.If your ID is longer then nine characters, you can use alias ID to correspond with MicroLoop, MicroLab or MicroDL ID's.When the data is uploaded from these spirometer's, it will try to match with the Patient ID or with Patient Alias ID. Thisallows you to have long ID's in Spida 5, yet the upload will load the data to the correct patient. Alias ID cannot be the sameas any other ID or any other Alias ID.Origin (Ethnic Origin) is used for adjusting the predicted values where Ethnicity is not defined. For most predicted values,origins other then Caucasians will be considered as Non-Caucasian. A correction factor of 12% for ages 6- 17 and 15% forages 18+ will apply for indices FEV1 and FVC for non-Caucasians. If other correction factors are required, then use thefactor field.

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A factor is used for changing the predicted value of FEV1 and FVC by the amount specified. For example, if the predictedvalue for FEV1 is 3.0L and factor set for 10%, then the predicted value will be 3.0L – 0.01 X 3.0L = 2.7L. The factor has no

effect on Crapo predicted values. Predicted Values.You can enter height as '5f4' or '5ft4' for 5 feet 4 inches, and it will be converted into the correct units. If your setting is inCm., you can also enter the height as '64i' for 64 inches or in the Inches setting, it can be entered as '163c' for 163 Cm.You can enter weight as '10s5' or '10st5' for 10 stones 5 pounds, or as '145p' (145 pounds), or 65.6k (65.6 Kg).Patient ID can be changed using the 'Change Patient ID' button.

Click the down arrow next to the Date of Birth box to reveal the date picker below.

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5.3.4 Delete Patient (Data menu)

This command removes a patient from the database, and all their examinations. To perform this task, the Delete functionmust first be enabled (which requires a password). See "Enable Delete" for more details.

WARNING: This process is irreversible.

5.3.5 Delete Examination (Data Menu)

This command removes the selected examination from the database. To perform this task, the Delete function must first beenabled (which requires a password). See "Enable Delete" for more details.

WARNING: This process is irreversible.

5.3.6 Enable Delete (Data Menu)

This command allows access to the 'Delete Patient' and 'Delete Examination' functions of the Data menu. A password isneeded to enable deleting for security reasons. The default is "Admin" (without quotes) Contact the Doctor in charge or thesystem administrator for the latest password. Once you have deleted the required data, it is advised that you disable thedelete function to protect your data.

5.3.7 Disable Delete (Data Menu)

This command removes the ability of the user to delete a patient or examination unless a password is entered. Once you havefinished deleting data, the command should be run to prevent unauthorized removal of data. To allow data to be removedagain, run Enable Delete from the Data menu (which requires a password).

5.3.8 Upload All (Data Menu)

Uploads all the data from the spirometer to Spida 5, even if the data has previously been uploaded. The upload button onlyuploads the data that has been added since the last upload. This makes it more efficient, but there are times when you mayneed to upload all the data, for example, when you open a new database, or change your PC.

When uploading all the data, if the data exist in Spida 5, then it will not be overwritten; only new data will be added in.

5.3.9 Change Password (Data Menu)

This command allows the user to change the password necessary to delete patients and examinations.Enter the current Password into the first box to ensure that you have the authority to change the Password.Enter the new password when requested, and confirm it by typing it again. If the confirmation Password does not match theoriginal Password, a message will be given. Retype it if necessary.

Warning: Without this password you will not be able to delete data.

If you want help on Enable delete function click here.

5.4 The Setup Menu

5.4.1 Predicted Values

Spirometry tests are interpreted by comparing the results with 'Predicted Values' (or sometimes called 'Reference Values').These 'Predicted Values' are usually obtained by performing studies on selected populations to obtain equations for specifiedindices to cover a selected age range.When performing these studies, factors that are usually taken into account are Age, Height and Gender, however they can alsodiffer with ethnic origin and weight, which not all sets take into account.

Two standard deviations are given for most predicted sets either side of the Normal values (Minimum and Maximum), whichusually covers the range of which the study was performed.

Predicted values will not give a true representation for all populations, which is why spida Spida incorporates numerous

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predicted sets, covering multiple origins

· Austrian· Crapo/HSU· Crapo/Polgar· ECCS· Knudson· Roca· Gutierrez· Eigen/Crockett· Pereira· Taiwan· Hedenstrom· NHANES III· Koillinen/Viljanen· Berglund· Cotes· Filipinos· Thailand· Mexican· New Zealand· Indonesian

Age RangesEach set may use one or more predicted value reference papers, for example the Crapo set uses 2 papers, 'HSU' for Childrenaged 7~18, and 'Crapo' for Adults aged 19~120. If a patient age is entered that is outside of the Predicted Sets age range thenthe predicted value will be given, but will use the maximum / Minimum age for the set in the equations, therefore truncating thepatient age.For example if using 'Crapo' and a patient age of 6 is used, then Predicted values will be given, however a patient age of 7 willbe used when calculating them.

If the entered patient age fell outside of the sets age range then the age used in the predicted value equations will be displayedin the Summary or results window.

If a patient age is entered in to spida which falls within the age ranges, the entered patient age will be used.

Height RangesEach age range of a set (If there is more than one) also uses a Height range. this height range is usually determined by thelowest and highest patient height that the predicted value study was performed on.if a patient is entered in spida with a height outside of the predicted sets height limit, it will truncate the height used in theequation to either the lowest or highest height for the set.For Example in the 'Crapo' set if a patient Age of 10 is entered with a Height of 100 cm it will calculate the predicted values forage range 1 (7~18 Years) using a height of 111cm. This is because Age Range 1 (HSU) height limit is 111~190cm, as 100cmfalls below the 111cm boundary range, the height used is truncated to the lowest boundary height.

If the entered patient height fell outside of the sets height range then the height used in the predicted value equations will bedisplayed in the Summary or results window.

If a patient height is entered in to spida which falls within the age ranges height boundary, the entered patient height will beused.

WeightSome predicted sets (such as Austrian), require a weight to be entered before predicted values can be given

IndicesThe indices given in each predicted set are only those specified on the reference paper. for example if the FEV1 and FVC arespecified but no FEV1/FVC. we do not calculate the FEV1/FVC by dividing the given Predicted FEV1 by the FVC.

Negative Predicted ValuesIf a Lower Limit predicted result is calculated to give a negative value, then Indices predicted Normal and Upper limit value willonly be given leaving the lower limit as blank.

If a Normal predicted value is calculated to give a negative value, then none of the Indices predicted values will be displayed(Lower Limit, Normal and Upper)

RatiosIndices given as Ratios (%) such as FEV1/FVC that calculate a predicted value over 100%, will truncate the result and displaythe predicted value as 100%

Correction Factors (Ethnic Origins)There are some predicted values that use different equations for different Ethnic Origins. For example NHANES III usesdifferent equations for Caucasian, Black and Hispanic. If a race correction factor is entered for the patient which is one of theseEthnic Origins, it will be ignored. this is because the equations have been specially calculated to give the predicted values forthat Origin.If a Origin is entered into spida which does not have its own equations, then the Caucasian set of equations will be used and

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the correction factor applied.

5.4.1.1 Changing the Predicted Value Set

Multiple Predicted sets are available in Spida.To change / view the list of predicted set available, please select 'Setup' -> 'Predicted Values'

To find out more information on each predicted set, please view the set description in this help document.

5.4.1.2 Correction Factor

No predicted set covers all ethnic origins, so it would be impossible for one set to cover all of the local population. For exampleAsian and African American patient's tend to have lower pulmonary function values than predicted's referred by ECCS, in thiscase an ethnic correction factor is subtracted from predicted values.

It is important to know if the set being used has already had a factor applied before entering a value. Some sets such asNHANES III and Crapo/HSU give sperate equations for different races. in this case if a correction factor has been entered forone of these races, it will not be used as the equation already takes into account the patients race. if the set does not specify aequation for each race or there is no equation for the race then the race correction factor will be used,

To find out what ethnic origin equations are available for each set in spida, please view the predicted set description in this helpdocument.

5.4.1.3 Predicted Sets

5.4.1.3.1 Austrian

Below are details of the predicted sets age and height boundaries, along with a list of Indices given for each age range. It alsospecifies if the Predicted set contains sperate equations for different Ethnic Origins as well as if the set requires a weight to beentered to generate the predicted values.

Male

Age Range Height Range (Cm) Weight Needed? Indices Ethnic

Origins

Availabl

e1) 6 ~ 17 109 ~ 196 Yes FEV1, FVC, PEF, FEV1/FVC, FEF25, FEF50, FEF75 N/A

2) 18 ~ 90 144 ~ 200 Yes FEV1, FVC, PEF, FEV1/FVC, FEF25, FEF50, FEF75 N/A

Female


Origins

Availabl

e1) 6 ~ 15 110 ~ 182 Yes FEV1, FVC, PEF, FEV1/FVC, FEF25, FEF50, FEF75 N/A

2) 16 ~ 90 140 ~ 190 Yes FEV1, FVC, PEF, FEV1/FVC, FEF25, FEF50, FEF75 N/A

ReferenceThe predicted equations were obtained from the following reference papers

Age Range 1: - Osteweichische Bezugswerte fur Spirometrie. G Forche, H Friedle, E Stadlober, K Harnoncourt.Age Range 2: - Osteweichische Bezugswerte fur Spirometrie. G Forche, H Friedle, E Stadlober, K Harnoncourt.

To see a list of other available predicted sets please see the 'Predicted Value Overview' section of this document

48


5.4.1.3.2 Berglund


Male


Origins

Availabl

e1) 7 ~ 19 115 ~ 179 No FEV1, FVC, VC, MVV N/A

2) 20 ~ 70 150 ~ 195 No FEV1, FVC, VC, FEV1/FVC N/A

Female


Origins

Availabl

e1) 7 ~ 19 121 ~ 178 No FEV1, FVC, VC, MVV N/A

2) 20 ~ 70 150 ~ 195 No FEV1, FVC, VC, FEV1/FVC N/A


Age Range 1: - Acta Pediatrica, 1963, By Jan Bjure (Ventilatory Capacities in Healthy Children 7 - 17 Years of age)Age Range 2: - Acta Medica, 1963 By E.Berglund, G. Birath, J. Bjure, G. Grimby, I. Kjellmer, L. Sanqvist and B. Soderholm

(Forced Expirograms in subjects between 7 and 70 years of age)7


5.4.1.3.3 Cotes


Male


Origins

Availabl

e1) 20 ~ 90 150 ~ 190 Yes FEV1, FVC, MVV, VC, PEF, FEV1/FVC, FEF25~75, FRC,

RV, TLC, RV/TLCN/A

Female

49



Origins

Availabl

e1) 20 ~ 90 140 ~ 180 Yes FEV1, FVC, MVV, VC, PEF, FEV1/FVC, FEF25~75, FRC,

RV, TLC, RV/TLCN/A

Note: - With this predicted sets, if an Age is entered which falls below the lower age limit, predicted values will not be given.This is because the set contains no child predicted values.


Age Range 1: - J.E. Cotes 1965


5.4.1.3.4 Crapo/HSU


Male


Origins

Availabl

e1) 7 ~ 18 111 ~ 190 No FEV1, FVC, PEF, FEF25~75 Cau

casian,Black,Hispanic

2) 19 ~ 120 110 ~ 200 No FEV0.5, FEV1, FEV3, FVC, FEV1/FVC, FEV3/FVC,FEF25~75

N/A

Female


Origins

Availabl

e1) 7 ~ 18 111 ~ 180 No FEV1, FVC, PEF, FEF25~75 Cau



N/A


Age Range 1: - Katharine H. K .Hsu, MD., * Daniel E, Jenkins, MD., Bartholowmew P. His, PHD., Erwin Bourhofer, VirginiaThompson, R.N., M.P.H., Nobuo Tanakawa, MD., and Grace S.J Hsieh, B.S., M.P.H., Houston, Texas,1979, (Ventilatory functions of normal children and young adults - Mexican- American, White and Black)

50


Age Range 2: - Crapo R O, Morris A H, Gardner R M. Reference Spirometric Values using techniques and equipment thatmeets ATS recommendations. Am Rev Respir Dis 1981, 123, 659 - 664;

Correction FactorNote: - If a correction factor is applied to one of the ethnic origins listed above that have dedicated equations then it shall be

ignored.


5.4.1.3.5 Crapo/Polgar


Male


Origins

Availabl

e1) 7 ~ 18 111 ~ 190 No VC, FEV1, FVC, MVV, PEF, PIF, FEF25~75, FRC, RV,

TLCN/A


N/A

Female


Origins

Availabl

e1) 7 ~ 18 111 ~ 180 No VC, FEV1, FVC, MVV, PEF, PIF, FEF25~75, FRC, RV,

TLCN/A


N/A


Age Range 1: - Polgar and Promadhat 1971Age Range 2: - Crapo R O, Morris A H, Gardner R M. Reference Spirometric Values using techniques and equipment that

meets ATS recommendations. Am Rev Respir Dis 1981, 123, 659 - 664;


5.4.1.3.6 ECCS


Male

51



Origins

Availabl

e1) 6 ~ 16 100 ~ 199 No VC, FEV1, FVC, IC, PEF, FEV1/FVC, FEF25, FEF50,

FEF75, FEF25~75, FRC, RV, TLC, RV/TLC, FRC/TLCN/A

2) 17 ~ 120 155 ~ 195 No VC, FEV1, FVC, PEF, FEV1/FVC, FEF25, FEF50, FEF75,FEF25~75, FRC, RV, TLC, RV/TLC, FRC/TLC

N/A

Female


Origins

Availabl




N/A


Age Range 1: - Indices FEV1, FVC, FEV1%, MMEF: Zapletal et al. Normal Values 1977, Indices MEF25, MEF50, MEF75:Solymar et al. 1980, Index PEF : Cogswell et al. Normal Values 1975.

Age Range 2: - European Respiratory Journal, Vol 6, Supplement 16 March 1993 Pages 26,27.

Correction FactorPatients with a ethnic origin of : -

· Hong Kong Chinese, should apply a correction factor of 0% (As per Caucasian Individuals)· Japanese American, should apply a correction factor of 11%· Polynesian, should apply a correction factor of 10%· North Indians and Pakistanis, should apply a correction factor of 10%· South Indians and those of African Descent, should apply a correction factor of 13%

Ref: Lung Volumes and forced Ventilatory Flows. P.H. Quanjer et al. European Respiratory Journal, 1993, 6, Supplement, 16Page 5 - 40.

Note: - The above correction factors are ONLY suitable when using the ECCS predicted set.


5.4.1.3.7 Eigen/Crockett


Male


Origins

Availabl

e1) 3 ~ 7 87 ~ 127 No FEV1, FVC, PEF, FEF25~75, FEV1/FVC, FEF25~75/FVC N/A

2) 8 ~ 17 120 ~ 190 No VC, FEV1, FVC, PEF, FEF25~75, FEF25, FEF50, FEF75,FIF50, TLC, RV

N/A

3) 18 ~ 120 110 ~ 200 No FEV1, FVC, PEF, FEF25~75, FEV1/FVC N/A

52


Female


Origins

Availabl

e1) 3 ~ 7 87 ~ 127 No FEV1, FVC, PEF, FEF25~75, FEV1/FVC, FEF25~75/FVC N/A

2) 8 ~ 17 120 ~ 176 No VC, FEV1, FVC, PEF, FEF25~75, FEF25, FEF50, FEF75,FIF50, TLC, RV

N/A

3) 18 ~ 120 110 ~ 200 No FEV1, FVC, PEF, FEF25~75, FEV1/FVC N/A


Age Range 1: - Eigen et al, Am J Respir Crit Care Med. (2001) 163: 619-623Age Range 2: - Hibbert et al, Paediatric Pulmonology. (1989) 7: 101-109.Age Range 3: - Spirometric Standards for healthy adult lifetime nonsmokers in Australia. CJ Gore, AJ Crockett, DG

Pederson, ML Booth, A Bauman, N Owen, Eur Resp J, 1995, 8, 773-782


5.4.1.3.8 Filipinos


Male


Origins

Availabl

e1) 20 ~ 70 151 ~ 180 No FEV1, FVC N/A

Female


Origins

Availabl

e1) 20 ~ 60 127 ~ 174 No FEV1, FVC N/A



Age Range 1: - Philippine College of chest physicians council on asthma, Prediction nomograms for spirometric values inFilipinos


53


5.4.1.3.9 Gutierrez


Male


Origins

Availabl

e1) 6 ~ 12 100 ~ 199 No FEV1, FVC, FEV1/FVC, FEF25~75 (All Other Indices

Taken From ECCS)N/A

2) 13 ~ 18 100 ~ 199 No FEV1, FVC, FEV1/FVC, FEF25~75 (All Other IndicesTaken From ECCS)

N/A


N/A


N/A

Female


Origins

Availabl

e1) 6 ~ 12 100 ~ 199 No FEV1, FVC, FEV1/FVC, FEF25~75 (All Other Indices

Taken From ECCS)N/A


N/A


N/A

3) 41 ~ 120 145 ~ 180 No FEV1, FVC, FEV1/FVC, FEF25~75 (All Other IndicesTaken FromECCS)

N/A


All Ranges: - Spirometric values for the Chilean population at sea level, Rev. Med Chile 1996; 124; 1295-1306 by MónicaGutiérrez.

Note: - This set only gives FEV1, FVC, FEV1/FVC and FEF25~75. All other Indices given are taken from the ECCS set


5.4.1.3.10 Hedenstrom


Male

54



Origins

Availabl

e1) 20 ~ 70 110 ~ 200 Yes VC, FEV1, FVC, PEF, FEV1/FVC, FEF25, FEF50, FEF75,

TLC, FRC, RV, FRC/TLC, RV/TLCN/A

Female


Origins

Availabl

e1) 20 ~ 70 110 ~ 200 Yes VC, FEV1, FVC, PEF, FEV1/FVC, FEF25, FEF50, FEF75,

TLC, FRC, RV, FRC/TLC, RV/TLCN/A



Age Range 1: - Male: Hans Hedenstrom, Reference values for lung function tests in men: Regression equations withsmoking variables, Upsala Journal of Medical Science 91: 299-310, 1986Female: Hans Hedenstrom,Reference values for lung function tests in men: Regression equations withsmoking variables, Bull. Eur. Physiopathol. Respir. 1985, 21, 551-557


5.4.1.3.11 Indonesian


Male


Origins

Availabl

e1) 13 ~ 70 150 ~ 172 No FVC, FEV1, PEF, FEV1/FVC N/A

Female


Origins

Availabl

e1) 13 ~ 70 150 ~ 172 No FVC, FEV1, PEF, FEV1/FVC N/A


Age Range 1: - Pneumobile Project, Indonesia 1992. By 3 Indonesian Universities in collaboration with Oregon University

55


and Boehringer Ingelheim


5.4.1.3.12 Knudson


Male


Origins

Availabl

e1) 6 ~ 11 112 ~ 155 No FEV1, FVC, FEF50, FEF75, FEF25~75 N/A

2) 12 ~ 24 140 ~ 193 No FEV1, FVC, FEF50, FEF75, FEF25~75 N/A



PEF RangeAge Range Height Range (Cm) Weight Needed? Indices Eth

nicOrigins

Availabl

e1) 6 ~ 15 110 ~ 180 No PEF N/A

2) 16 ~ 84 140 ~ 196 No PEF N/A

FEV1/FVC RangeAge Range Height Range (Cm) Weight Needed? Indices Eth

nicOrigins

Availabl

e1) 6 ~ 24 112 ~ 193 No FEV1/FVC N/A

2) 25 ~ 84 157 ~ 196 No FEV1/FVC N/A

Female


Origins

Availabl

e1) 6 ~10 106 ~ 147 No FEV1, FVC, FEF50, FEF75, FEF25~75 N/A

2) 11~ 19 132 ~ 183 No FEV1, FVC, FEF50, FEF75, FEF25~75 N/A




PEF Range

56



Origins

Availabl

e1) 6 ~ 15 110 ~ 180 No PEF N/A

2) 16 ~ 87 135 ~ 180 No PEF N/A

FEV1/FVC RangeAge Range Height Range (Cm) Weight Needed? Indices Eth

nicOrigins

Availabl

e1) 6 ~ 19 106 ~ 183 No FEV1/FVC N/A

2) 20 ~ 87 147 ~ 180 No FEV1/FVC N/A


All Age Ranges: - Ronald J.Knudson, Michael D.Lebowitz, Catherine J.Holberg, Benjamin Burrows(Changes in the NormalMaximal Expiratory Flow-Volume Curve with Growth and Aging (Am Rev Respir Dis 1983; 127: 725-734)


5.4.1.3.13 Koillinen/Viljanen


Male


Origins

Availabl

e1) 5 ~ 17 110 ~ 180 No VC, FEV1, FVC, PEF, FEV1/FVC, FEF50, FEV0.5,

FEV0.5/FVC,N/A

2) 18 ~ 65 100 ~ 199 No VC, FEV1, FVC, PEF, FEV1/FVC, FEF50, FEF75 N/A


N/A

Female


Origins

Availabl

e1) 5 ~ 17 110 ~ 170 No VC, FEV1, FVC, PEF, FEV1/FVC, FEF50, FEV0.5,

FEV0.5/FVC,N/A

2) 18 ~ 65 100 ~ 199 No VC, FEV1, FVC, PEF, FEV1/FVC, FEF50, FEF75 N/A


N/A

57



Age Range 1: - Terveiden suomalaislasten spirometrian ja uloshengityksen huippuvirtauksen viitearvotAge Range 2: - AA Viljanen, Spirometric Studies in non smoking, heathly adults, J. Clin. Lab Invest.41 Supp. 159, 5-20

1981Age Range 3: - European Respiratory Journal, Vol 6, Supplement 16 March 1993 Pages 26,27.


5.4.1.3.14 Mexican


Male


Origins

Availabl

e1) 8 ~ 20 101 ~ 193 Yes FEV1, FVC, PEF, FEF50, FEF25~75, FEV1/FVC N/A

2) 21 ~ 65 142 ~ 190 Yes FEV1, FVC, FEF50,FEF75, FEF25~75, FEV1/FVC N/A

Female


Origins

Availabl

e1) 8 ~ 20 109 ~ 177 Yes FEV1, FVC, PEF, FEF50, FEF25~75, FEV1/FVC N/A

2) 21 ~ 65 135 ~ 174 Yes FEV1, FVC, FEF50,FEF75, FEF25~75, FEV1/FVC N/A


Age Range 1: - Spirometric function in children of Mexico city compared to Mexican -American children, PediatricPulmonology 35:177-183 (2003), Rogelio Perez- Padilla

Age Range 2: - Jose Rogelio, Spirometry Reproducibility and reference values in Mexican workers claiming disability,Salud Publica Mex 2001; 43:113-121


5.4.1.3.15 New Zealand


Male

58



Origins

Availabl

e1) 25 ~ 74 147 ~ 190 Yes FEV1, PEF, FEF25~75, FEF25, FEF50, FEF75, FEV6,

FVC, FEV1/FVC, FEV1/FEV6, SVC, IC, FRC, TLC, RV,ERV, RV/TLC

N/A

Female


Origins

Availabl

e1) 25 ~ 74 147 ~ 190 Yes FEV1, PEF, FEF25~75, FEF25, FEF50, FEF75, FEV6,

FVC, FEV1/FVC, FEV1/FEV6, SVC, IC, FRC, TLC, RV,ERV, RV/TLC

N/A



Age Range 1: - Marsh et al, The New Zealand Medical Journal, Vol 119 No 1244 ISSN 1175 8716


5.4.1.3.16 NHANES III


Male


Origins

Availabl

e1) 6 ~ 7 115 ~ 180 No FEV1, FVC, FEV1/FVC Cau

casian,Black

2) 8 ~ 20 120 ~ 200 No FEV1, FEV6, FVC, PEF, FEF25~75 Caucasian,Black,Hispanic

3) 21 ~ 80 120 ~ 200 No FEV1, FVC, FEV1/FVC Caucasian,Black,Hispanic

FEV1/FVC & FEV1/FEV6 Range

59



Origins

Availabl

e*) 8 ~ 80 120 ~ 200 No FEV1/FVC, FEV1/FEV6 Cau


Female


Origins

Availabl

e1) 6 ~ 7 115 ~ 180 No FEV1, FVC, FEV1/FVC Cau

casian,Black



FEV1/FVC & FEV1/FEV6 RangeAge Range Height Range (Cm) Weight Needed? Indices Eth

nicOrigins

Availabl

e*) 8 ~ 80 110 ~ 190 No FEV1/FVC, FEV1/FEV6 Cau



Age Range 1: - Xiaobin Wang, Pulmonary Function Between 6 and 18 years of age, Pediatric Pulmonology15:75-88 (1993)

Age Range 2 , 3 & * : - John L Hankinson,Sirometric Reference Values from a sample of the general US population –AM J RESPIR CRIT CARE MED 1999; 159:179-187

Correction FactorPatients with a ethnic origin of Asian or Eastern Indians should apply a race correction factor of 6%.Note: - If a correction factor is applied to one of the ethnic origins listed above then it shall be ignored.


60


5.4.1.3.17 Pereira


Male


Origins

Availabl

e1) 6 ~ 14 112 ~ 155 Yes FEV1, FVC, FEV1/FVC, FEF25~75, FEF25~75/FVC N/A

2) 15 ~ 24 140 ~ 193 Yes FEV1, FVC, FEV1/FVC, FEF25~75, FEF25~75/FVC N/A

3) 25 ~ 78 140 ~ 193 Yes FEV1, FVC, FEV1/FVC, FEF25~75, FEF25~75/FVC,FET25~75, MVV

N/A

Female


Origins

Availabl

e1) 6 ~ 14 112 ~ 155 Yes FEV1, FVC, FEV1/FVC, FEF25~75, FEF25~75/FVC N/A

2) 15 ~ 19 140 ~ 193 Yes FEV1, FVC, FEV1/FVC, FEF25~75, FEF25~75/FVC N/A

3) 20 ~ 76 140 ~ 193 Yes FEV1, FVC, FEV1/FVC, FEF25~75, FEF25~75/FVC,FET25~75, MVV

N/A


Age Range 1: -Age Range 2: -


5.4.1.3.18 Roca


Male


Origins

Availabl

e1) 6 ~ 20 100 ~ 199 Yes FEV1, FVC, PEF, FEF50, FEF75, FEF25~75 N/A

2) 21 ~ 120 140 ~ 199 Yes FEV1, FVC, PEF, FEV1/FVC, FEF50, FEF75, FEF25~75 N/A

Female

61



Origins

Availabl

e1) 6 ~ 20 100 ~ 199 Yes FEV1, FVC, PEF, FEF50, FEF75, FEF25~75 N/A

2) 21 ~ 120 135 ~ 199 Yes FEV1, FVC, PEF, FEV1/FVC, FEF50, FEF75, FEF25~75 N/A


Age Range 1: - J Roca et al. Bult. Eur. Physiopathol. Respir. 1986, 22, 217-224.Age Range 2: - J Roca et al. Bult. Eur. Physiopathol. Respir. 1986, 22, 217-224.


5.4.1.3.19 Taiwan


Male


Origins

Available

1) 6 ~ 16 100 ~ 199 No VC, FEV1, FVC, IC, PEF, FEV1/FVC, FEF25, FEF50,FEF75, FEF25~75, FRC, RV, TLC, RV/TLC, FRC/TLC

N/A

2) 17 ~ 120 155 ~ 195 No FEV1, FVC, PEF, FEV1/FVC, FEF35, FEF50, FEF75 N/A

Female


Origins

Availabl



2) 16 ~ 120 145 ~ 180 No FEV1, FVC, PEF, FEV1/FVC, FEF35, FEF50, FEF75 N/A


Age Range 1: - Indices FEV1, FVC, FEV1%, MMEF: Zapletal et al. Normal Values 1977, Indices MEF25, MEF50, MEF75:Solymar et al. 1980, Index PEF : Cogswell et al. Normal Values 1975.

Age Range 2: - Journal Formosan Medical Association, 80, 19-29, 1981, Study of maximal expiratory flow and volume inChinese, normal nonsmoking adults, Min Chein Wu


5.4.1.3.20 Thailand


Male

62



Origins

Availabl

e1) 10 ~ 87 125 ~ 185 No FEV1, FVC, FEV1/FVC, PEF, FEF25~75 N/A

Female


Origins

Availabl

e1) 10 ~ 92 121 ~ 184 No FEV1, FVC, FEV1/FVC, PEF, FEF25~75 N/A


Age Range 1: - Reference Spirometric Values for Healthy Lifetime nonsmokers in Thailand,J Med Thai May 2000, 457:466


5.4.2 Setup Menu Commands

The Setup Menu offers the following commands:

Options Set the operation mode of Spida 5.

Indices Select the indices to be displayed in the result view.

Reports Select the type of printed report.

Trend Select the parameters to show on trend plot.

Predicted Values Select the type of predicted values.

Child Incentive Set the criteria when the bubble should burst

Device Configuration Performs device-specific configuration.

Calibration Check Launches the Calibration Check Tool

Customisation Wizard Launches the Customisation Wizard for configuring Spida.

63


5.4.3 Options (Setup Menu)

The options box allows the user to customize how SPIDA 5 will work.The options that can be changed are the following: -

Best Criteria: Sets which parameters are used when deciding the best blow.

Com Port: Set the serial or USB port connected to the spirometer.

Show Grids: If you select this option, your graph windows will display a background grid tohelp you compare the values on the graph.

Prompt:: Reminder to switch on the Spirometer. Prior to the first blow of every test, areminder appears to switch on your spirometer. If you find this annoying, just setPrompt to OFF, but remember to switch on your spirometer before starting a liveexamination.

Show Composite Curve: If this option is selected, then the composite curve will be displayed in a yellowhighlighted line of the test view. This virtual curve is made out of the outline of theexpiratory flow/volume curves, and its indices are selected as the best indices forthis base, post1 or post 2 session. If selected, the composite curve will replacethe best selection, and the best criteria will only be used to assess the variationbetween consecutive tests.Select this option to comply with the ATS/ERS 2005 criteria

Show Extended Tool tips: Select to show tool tips when the mouse pointer remains over menu items.

Use VC instead of FVC Select to use VC instead of FVC (if available) for calculating %FEV1.

Show Relaxed Data Select to use the relaxed mode – including a relaxed test section in thedatabase, two relaxed graph views for tidal efforts and a new results view forrelaxed indices.

PEF Units The units used when displaying the PEF, either Litres per second or Litres perMinute.

Height Units: The units used when displaying the height, either Centimetres or Inches.

Weight Units: The units used when displaying the weight, either Kg or Lbs.

Flow type: Allows the user to look at the expiratory loop only, or both the expiratory andInspiratory loops together. If you are using spirometer's with expiration only or areonly interested in expiration tests, then select Expiratory only, this will only showexpiratory information and will utilize the screen area better.

Predicted Area/Line: Select Predicted Area or line to be displayed in the Best FVL view and All FVLView. The area is determined from predicted indices of PEF, MEF75, MEF50,MEF25 and FVC. For some predicted values (for example Crapo), MEF valuesare unavailable,. In such cases, predicted area will be determined from PEFand FVC.The predicted Line is always determined from PEF and FVC values. Select noneif no area or line is required.

Interpretation Type: Select Enright, ATS or NICE - these selections give a choice of standardinterpretations. Click here to see the algorithms used for each.

Print Title: Sets the title that will appear on the top of the printed report. The first line is in alarger font and is meant for the Hospital or clinic name, and the second line is ina smaller font for the address etc. Of course you can use it for any purpose youprefer. Use the Print Preview function to check that the information appears asexpected.

64


5.4.4 Indices (Setup Menu)

You will be presented with a tab view giving access to configure the forced indices (and optionally relaxed) to be included inthe results view window, export to word and the printed report.Select the indices you would like to display by checking the boxes to the left of the index title. There is no limit to the numberof indices you can select, but be aware that the same indices will be printed out in the report. Selecting too many indices willmake the report unnecessarily long.

The ability to show relaxed indices separately can be activated from the setup options.

Result View

5.4.5 Report (Setup Menu)

Select the sections you need to be printed in your report. Select also the page size and top margins.

The following sections are available:

TitlePatient DetailsPatient historyMedicationSummary of all the testsSelected indices of the best blowInterpretationPrint Large ATS/ERS Recommended GraphsFlow Volume Loop and Volume Time GraphExamination NotesSignature Line

65


Summary of All the ExaminationsTrend GraphsRelaxed Volume Time GraphsSummary of Relaxed TestsRelaxed Indices

Note: The Relaxed items are only available if the show relaxed option has been set in setup options.

5.4.6 Trend (Setup Menu)

Select the parameters to trend on. You can select any number of parameters. However, if you select PEF (L/S) and anyother parameter with units of Litres, then the y-axis will not have any units.

Trend View

5.4.7 Child Incentive (Setup Menu)

Set the child incentive values.For the first blow, the value required to reach the target is as a percentage of the predicted value (default 100%). Changethis value if you want to set the target at a different value, say 80%.

66


For subsequent blows, the patient has to exhale a percentage of the best blow for the target to be reached (default 100%).Change this to encourage the patient to do better then the previous best blow. A value of 110 % would be appropriate.The new values will be remembered, therefore you don't have to set it every time.

Setting The Child Incentive ViewPlease see 'Setup the Child Incentive view' in the How to section of this help document / file for more information

Child Incentive TypeThe type of visual incentive is determined by your choice of option between a skateboarder race, a bubble gum kid, milkshake kid or Wolf.In the skate board race, the blow will determine the position of the skate boarder on the right, and the opponent will bedefeated if the target is reached.If the bubble gum kid is selected, a boy will be blowing a bubble gum, which will pop if the target is reached.The milk shake kid blows bubbles into the milk shake and they overflow when the target is reached.The Wolf will take a deep breath and blow the straw house away once the target has been reached.

5.4.8 Device Configuration (Setup Menu)

This menu item will allow you to access device specific configuration menus.Simply connect the device to PC and click this item to launch the menu.

For most devices, it will allow you to set-up the date / time and reset the memory.For more recent ones, it will ask you to chose between Inspiratory and expiratory relaxed manoeuvres and even relaxedtidal.Click here to find out about the MicroDL configuration.

5.4.9 Calibration Check (Setup Menu)

The calibration check facility is provided to help verify that the device is within the calibration limits (+- 3% of expected volume).We recommend that it is be performed each day before the device is used (more calibration checks may be performed in thesame day if user requires)

Performing a daily calibration check helps determine any invalid calibration results within the first day of the issue arising, aswell as providing day-to-day laboratory variability.

The calibration tool has been designed to meet the 'ATS ERS Standardisation of lung function testing' requirements as well asa quick simple method.The ATS ERS recommends that during a calibration check, the user will need to perform three syringe waveforms (Minimum of

67


1) for three different flow rates (Between 0.5 and 12 L/Sec). The purpose of this is to help identify any invalid calibration resultsat various flow rates.

Starting the Calibration CheckThe calibration check can be found under the 'Setup' menu in Spida and then selecting 'Calibration Check'.Spida will then close and the calibration check tool will open

Please click here for a step by step guide through the calibration process, or click 'Next' at the top of this help screen

Before proceeding please verify that the device that is going to perform the calibration check, is connected to the PC via aSerial or USB cable (Depending on the device type)

Calibration SyringesTo help achieve improved results during a calibration check, Please Verify the following: -

1. The syringe used to perform the calibration check on the device, should have a accuracy of +- 15ml or +-0.5 % ofthe syringe volume (15ml for a 3 Litre syringe)

2. Syringes with adjustable or variable stops may be out of calibration if the stop is accidentally moved or reset.3. Calibration syringes should be leak tested periodically (Monthly) by blocking the air outlet and applying pressure on

the syringe handle (A dropped or damaged syringe should be leak tested before a calibration check is performed)4. The calibration syringe is kept with the spirometer (Not in direct Sunlight or any heat sources) to help maintain the

same temperature and humidity of the testing location

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5.4.10 Customisation Wizard (Setup)

The Customisation Wizard is an independent way for setting the configuration options for Spida without having wade through allthe application setup dialogs.

Upon selecting this option the Customisation wizard application will start and Spida will exit to be re entered when theCustomisation wizard is finished.

The Customisation wizard will guide you through setting up Spida for your individual needs in an easy and intuitive way using acollection of simple pages in a window (see below)

Click here to go through the various screens offered.

5.5 The Window Menu

5.5.1 Window Menu Commands

The Window Menu offers the following commands:CascadeTileArrange Icons

It also offers a list of the currently open views within Spida with a tick against the view that is activated. Bring a view fromthis list to the foreground of the main window by clicking on it.

5.5.2 Cascade (Window Menu)

This command arranges all the windows on top of each other with only the title bar of each window showing.

5.5.3 Tile (Window Menu)

This command fills the SPIDA window with all the open windows, maximizing space.

If you prefer this setting, select Save Settings from the View Menu and it will be remembered. To maximize the windowsize, close windows you do not need. If you want to open a closed window, select it from the View menu.

If you are not happy with the arrangement, do not save it and your previous settings will be restored next time you runSPIDA 5.

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5.5.4 Arrange Icons (Window Menu)

When a window is minimized, it appears as a bar icon at the bottom of the main window. This icon can be moved anywherearound the SPIDA screen. To open the window, double click on the icon."Arrange Icons" lines up these minimized windows at the bottom of the SPIDA window for your convenience.

5.6 The Help Menu

5.6.1 Help Menu Commands

The Help Menu offers the following command:Help TopicsRegister Spida 5Check for UpdatesAbout SPIDA 5

5.6.2 Help Topics (Help Menu)

Opens this help file.

5.6.3 Register Spida 5 (Help Menu)

This window will allow you to register your purchased version of Spida 5. If you haven't registered yet, you will only beallowed to use Spida 5 for 30 days.During this trial period, we strongly advise you to fill in the relevant details inside this box and to send by any of the providedmeans your details in order to get from us an authorization key which will unlock the software for you.Note that you will only need to do this ONCE!Finally once you receive the key from our registration team, simply enter the key inside the authorization key box, and pressApply.

5.6.4 Check for Updates (Help Menu)

This command will allow you to check the Micro Medical web server for updates to your Spida 5 software.To do this, you will need an Internet connection.The update wizard will automatically compare the version of Spida 5 you are running against the version available on thewebsite, and offer you to download it if necessary.This is a very easy operation, which allows you to keep using our latest software, at no extra cost!

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5.6.5 About SPIDA 5... (Help Menu)

This option will open a box giving information about Spida 5 including the Version number, serial number and copyrightinformation.

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6 Other Features

6.1 Interpretation

Interpretation is based on an algorithm published by Enright et al. ATS (BTS) or NICE. The selection can be made in theOptions Setup screen.

The algorithms flow charts are as follows:

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6.2 Composite Curve

Enabling this feature in the 'Option' screen performs multiple functions, when calculating the best effort as well as displayingthe best curve.

1. The best FEF25-75 result displayed in the Forced Results window, Summary Results window and on the printed reportsis the effort with the biggest FEV1 + FVC from all acceptable blows ('Good Blow' or 'Short Blow').If the patient has not produced any acceptable blows, then the effort with the biggest FEV1 + FVC from the includedtests shall be used.

2. A new row under each drug stage highlighted in yellow, within the patient data window will be added. Selecting this Rowwill display the best result from all indices, from all of the acceptable blows ('Good Blow' or 'Short Blow').If the patient did not manage to obtain an effort with a blow quality of either 'Good Blow' or 'Short Blow', then theselected best criteria will be applied to all efforts (with any blow quality), and the blow with the biggest best criteria isincluded and reported as the best effort.Note: - If only one drug stage effort is performed the yellow best individual row will not be displayed as only one blowsresults can be reported as best. Two or more tests are required to display the individual best row of results.

3. The Best FVL graph will display an envelope curve of all acceptable blows. The Expiratory curve is an outline off allacceptable efforts ('Short Blow' and 'Good Blow') starting from the TLC position, and the Inspiratory is an outline curveof all acceptable blows ('Short Blow' and 'Good Blow') starting from the RV position.

4. All indices with a unacceptable blow ('Slow Start', 'Abrupt End', 'Cough', 'Poor Effort' and 'Low Volume' ) will beexcluded from calculating the individual best results, Only acceptable blows such as 'Good Blow' or 'Short Blow' areused.If no acceptable blow has been performed then an effort with the biggest value for the selected best criteria is includedand set as best.If composite curve is disabled the automatic exclude will not occur and all efforts are included and are eligible to be thebest effort based of the best criteria, no matter the effort blow quality.

Note: -1. When recalculating the composite curve the recalculated Inspiratory curve is joint at the RV position of the expiratory

curve.2. The automatic exclude of unacceptable quality blows is only performed once the user selects 'Accept + Done' during a

live test or on uploading the data from a unit. It is not performed when enabling or disabling the composite curve (i.e. if alive exam has been performed with composite disabled and then the user enables this feature, it will not run theautomatic exclude feature. The user will have to manually exclude the unacceptable blows).For the same reason databases created before Spida 5 v2.0.7 will also not automatically exclude the unacceptableefforts, this will need to be done manually.

6.3 Include / Exclude manoeuvre

In the patient data window, the user has the option to include or exclude a manoeuvre from the finalresults.

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To Include an excluded manoeuvre, right click on a excluded test in the patient data window and selectInclude. (Simply reverse the procedure to exclude a included blow).

Excluded blows are not used for determining if the ATS/ERS Reproducibility criteria, so by including orexcluding tests may change the drug stage ATS/ERS Reproducibility being Met.

When 'Show composite Curve' is enabled in the 'Options' menu, and either a live test is performed or aexam uploaded, Spida will automatically exclude unacceptable blows (Blow qualities other than 'GoodBlow' or 'Slow Start'), and display the individual best results and composite curve only on theacceptable ones ('Good Blow' or 'Slow Start')If an acceptable blow has not been performed then the blow with the biggest set criteria (with any blowquality) is included and set as the best test. The individual best results and composite curve given aremade only from this effort.If composite curve is disabled the automatic exclude will not occur and all efforts are included and areeligible to be the best effort based of the best criteria, no matter the effort blow quality.

Note: - If the Composite curve is disabled the Best effort can not be excluded until another effort hasbeen selected as best

6.4 Best Criteria

After an examination has been performed, Spida automatically selects the best effort for each drugstage using the best criteria as specified in the 'options' screen.

FVC - It will automatically select the effort with the biggest FVCFEV1 - It will automatically select the effort with the biggest FEV1PEF - It will automatically select the effort with the biggest PEFFEV1+FVC - It will automatically select the effort with the biggest FEV1 + FVC

If the composite curve is enabled within the options screen, all efforts performed with a unacceptableblow quality (a quality other than 'Good Blow' or 'Slow Start'), are excluded from calculating the bestresults, only acceptable blows are used to derive them.If no acceptable blow has been performed, Spida will then apply the selected best criteria to all efforts(with any blow quality), and the blow with the biggest best criteria is included and reported as the besteffort.The individual best results will be displayed as a new row under each drug stage within the patient datawindow.

If the user wishes to override the automatically Include / excluded function, that is used to determinethe ATS/ERS Reproducibility criteria and the current best selected test, simply right click on thedesired effort on the patient data window, and select Include or exclude from the drop down menu.Click here for further information.

Note: - A minimum of one test must be included

6.5 ATS/ERS Criteria 2005

To enable all features to comply with ATS/ERS 2005 Criteria, Enable / Disable the following options: -

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Options MenuSelect the following options in the 'Options' Menu

Show Composite Curve Enabled

Show Relaxed Data Enabled

Interpretation 'ATS'

Flow Type 'Expiratory + Inspiratory' (If your device supports Inspiratory flows)

Reports MenuSelect the following options in the 'Reports' Menu

Print large ATS/ERS Recommended Graphs Enabled

Indices MenuSelect the following options in the 'Indices' Menu

IC (Forced) Enabled

IC (Relaxed) Enabled

FEF25-75 Enabled

ViewFrom the 'View' drop down menu in the main screen, select the following screens (In addition to otherdesired windows)

Best VTG Enabled

All VTG Enabled

Best FVL Enabled

All FVL Enabled

Forced Results Enabled

Relaxed Results Enabled

Reference : - "ATS/ERS Task Force: Standardisation Of Lung Volume Testing", Eur Respir J 200526:319-338.

6.6 Forced ATS/ERS Reproducibility Criteria

As forced spirometry tests are performed by a patient, Spida checks to see if the efforts obtained meet the ATS/ERSReproducibility criteria.

The results from this check are displayed in the Forced Results window in the bottom frame.

To meet ATS/ERS Reproducibility criteria· A minimum of 3 acceptable FVC maneuvers are required (Acceptable maneuvers are blow which resulted in a 'Good

Blow' or 'Short Blow' quality check).· If the FVC is bigger than 1 Litre, two of these three acceptable efforts should have a FVC and FEV1 less than or equal to

150ml of each other.· If the FVC is less than or equal to 1 Litre, two of these three acceptable efforts should have a FVC and FEV1 less than or

equal to 100ml of each other.

The colour of the text within the Forced Results window regarding the ATS/ERS Reproducibility criteria and interpretation willchange depending upon its status.· If the ATS/ERS Reproducibility criteria is not met then it will be displayed in Red.· If the ATS/ERS Reproducibility criteria is has been met then it will be displayed in Green.· If the ATS/ERS Reproducibility criteria is has been met, however the interpretation is anything other than 'Normal

Spirometry', then it will be displayed in yellow.

Note: - The "ATS/ERS Task Force: Standardisation Of Lung Volume Testing" requirements specifies that blows performedwith a bad blow quality should be excluded from the results. For spida to automatically exclude bad quality blowsduring a live test or on upload, Spida has to have the 'Show Composite Curve' enabled in the Options screen.

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If 'Show Composite Curve' is not enabled, all tests are included on a live test or on upload (This has been done sothat Spida displays the same results as the best effort as the devices it was uploaded from if the best criteria is set tosomething other than Individual best (such as the MicroLab Mk8, Mk6 etc)). The ATS/ERS Reproducibility text willthen be based on all blows, however users can manually exclude bad quality blows from the patient data viewwindow, if they require true ATS/ERS Reproducibility description based on only good quality blows ('Good Blow' or'Short Blow').


6.7 Relaxed ATS/ERS Reproducibility Criteria

As Relaxed Tidal, Expiratory or Inspiratory spirometry tests are performed by a patient, Spida checks to see if the effortsobtained meet the ATS/ERS Reproducibility criteria.

The results from this check are displayed in the Relaxed Results window in the bottom frame.

To meet ATS/ERS Reproducibility criteria· A minimum of 3 VC maneuvers are required· Two of these three acceptable efforts should have a VC less than or equal to 150ml of each other.

The colour of the text within the Relaxed Results window, regarding the ATS/ERS Reproducibility criteria will change dependingupon its status.· If the ATS/ERS Reproducibility criteria is not met then it will be displayed in Red.· If the ATS/ERS Reproducibility criteria is has been met then it will be displayed in Green.


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