The Council on Diagnostics and Therapeutics (DATS) within the Philippine College of Chest Physicians (PCCP) focuses on advancing lung health practices by setting standards, advocating for appropriate diagnostic/therapeutic tools (like PFTs, bronchoscopy), publishing guidelines, conducting education (webinars, lay forums), and promoting research in chest medicine, working on initiatives from COVID-era protocols to new tech use, highlighting PCCP's role in standards and innovation in Philippine pulmonary care.

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Public Advisory on the Interpretation of Spirometry

Spirometry is a medical test used to measure lung function and plays a key role in diagnosing and managing conditions such as asthma, chronic obstructive pulmonary disease (COPD), and other respiratory illnesses. While the test itself may appear straightforward, its interpretation is not. International standards emphasize that spirometry results must always be reviewed within the proper clinical context and by appropriately trained medical professionals. We are increasingly concerned about the growing practice of spirometry results being interpreted by non-physicians and physicians without formal or adequate training in respiratory medicine. Allied health professionals play a crucial role in delivering high quality spirometry and ensuring accurate and reliable results. However, interpreting those results and making diagnostic conclusions are medical acts that fall within the practice of medicine.

Consensus Position

1. The interpretation and official validation of spirometry results are medical responsibilities and must be performed by licensed physicians.
2. Pulmonologists are specifically trained to interpret spirometry due to specialized training in respiratory physiology, pulmonary pathology, and clinical correlation.
3. Interpretation by non-physicians or inadequately trained physicians may result in:

• o Incorrect or delayed diagnosis
• o Inappropriate or potentially harmful management decisions
• o Failure to recognize technical limitations or co-existing conditions
• o Increased medico-legal risk and patient harm

Why Spirometry Interpretation Requires a Physician The American Thoracic Society (ATS) and European Respiratory Society (ERS) emphasize that spirometry interpretation is not a purely numerical or automated process and requires:

• • Clinical history and physical examination correlation
• • Assessment of test acceptability and reproducibility
• • Differentiation of obstructive, restrictive, and mixed ventilatory defects
• • Evaluation of bronchodilator responsiveness
• • Integration with imaging, laboratory results, and comorbid conditions

Automated spirometry interpretations must not be used as the sole basis for diagnosis, as they are prone to misclassification and must be reviewed by a physician.

Role of Allied Health Professionals
Allied health professionals play a vital role in spirometry services. Their responsibilities include:

• • Performing spirometry tests
• • Coaching patients to achieve acceptable and reproducible maneuvers
• • Ensuring quality control and identifying technical errors
• • Providing technical observations related to test performance They are not authorized to make medical diagnoses or to formally interpret and sign spirometry reports for clinical or legal purposes.

Role of Non-Pulmonologists
Non-pulmonologists may appropriately request spirometry for:

• • Screening and Diagnosis of respiratory conditions, including ocuppational lung diseases
• • Pre-operative assessment
• • Monitoring response to treatment

Abnormal, complex, or unclear results should be reviewed or co-managed with a pulmonologist to ensure accurate interpretation and appropriate care. Legal and Ethical Considerations In the Philippines, interpreting diagnostic tests such as spirometry is considered the practice of medicine under the Medical Act of 1959. Interpretation by unlicensed or inadequately trained individuals may expose both individuals and institutions to professional sanctions, legal liability, and patient safety risks. Healthcare institutions should ensure that all spirometry reports clearly indicate the interpreting physician’s name, signature, and Professional Regulation Commission (PRC) license number.

Message to the Public

Patients undergoing spirometry are advised to:

• • Confirm that their results are interpreted by a licensed pulmonologist
• • Be cautious of diagnosis based solely on machine-generated or non-physician interpretations
• • Seek referral to a pulmonologist for complex or abnormal results

Key Roles & Activities:

Guideline Development: Creates and updates guidelines for lung-related procedures and diagnostics.
Advocacy: Promotes best practices for lung health, including advocating for essential procedures and addressing misinformation.
Education: Organizes scientific meetings, workshops, and public awareness campaigns (like Spirometry Week).
Research: Supports studies, like feasibility reports for simulation centers, and collects data for registries (e.g., lung cancer).
Collaboration: Works with other PCCP councils and international bodies to enhance care.

Examples of Council Work:

COVID-19 Pandemic: Issued recommendations for essential lung procedures.
Pulmonary Function Testing (PFTs): Conducted awareness drives and guidelines.
Technology Integration: Involved in discussions on digital health, AI, and social media use in respiratory care (via Health Informatics Council).
Interventional Pulmonology: Develops standards for bronchoscopy and pleural procedures (via IP Council).

In essence, the PCCP's DATS Council ensures pulmonologists have the best tools, knowledge, and standards to diagnose and treat lung diseases effectively in the Philippines.

Click to download : Council report 2022-2023