ATS Reading List

Pulmonary Function Testing

General reviews

The following ATS/ERS statements are widely recognized as the standard by which clinicians and researchers perform and interpret pulmonary functions tests:

Miller MR, Crapo R, Hankinson J, et al. ATS/ERS Task Force. General considerations for lung function testing. Eur Respir J. 2005; 26:153-61 Eur Respir J. 2005; 26:153-61.
PMID: 15994402
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Miller MR, Hankinson J, Brusasco V, et al; ATS/ERS Task Force. Standardisation of spirometry. Eur Respir J. 2005; 26:319-38.
PMID: 16055882
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Wanger J, Clausen JL, Coates A, et al. ATS/ERS Task Force. Standardisation of the measurement of lung volumes. Eur Respir J. 2005; 26:511-22.
PMID: 16135736
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Macintyre N, Crapo RO, Viegi G, et al. ATS/ERS Task Force. Standardisation of the single-breath determination of carbon monoxide uptake in the lung. Eur Respir J 2005; 26:720-35.
PMID: 16204605
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Pellegrino R, Viegi G, Brusasco V, et al. Interpretative strategies for lung function tests. Eur Respir J 2005: 26:948-68. An excellent comprehensive review of reference equations, types of ventilatory defects, PFT and DLCO interpretation, severity classifications, bronchodilator response thresholds, central and upper airway processes, and interpretation of changes in pulmonary function. This includes a recommendation to use the lower limit of normal when interpreting pulmonary function tests, an issue which is discussed in more detail in the article below.
PMID: 16264058
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Miller MR, Quanjer PH, Swanney MP, et al. Interpreting lung function data using 80% predicted and fixed thresholds misclassifies more than 20% of patients. Chest 2011;139:52-9. In addition to a discussion of the diagnostic errors associated with use of the fixed FEV1/FVC ratio of 0.7, this article highlights the misclassification associated with fixed 80%-predicted thresholds for spirometry variables. The authors suggest the fifth-percentile should be used to determine the lower limit of normal for spirometric variables and ratios.
PMID: 20522571
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Exercise Testing

Weisman IM, Zeballos RJ. Clinical exercise testing. Clin Chest Med 2001;22:679-701. The focus is on cardiopulmonary exercise testing, but this review also briefly summarizes the 6-minute walk, testing for exercise-induced bronchoconstriction, and cardiac stress testing. An excellent starting point for the novice.
PMID: 11787659

ATS/ACCP Statement on cardiopulmonary exercise testing. Am J Respir Crit Care Med 2003; 167:211-77. Somewhere between a textbook and a clinical review, this article provides more details on CPET than the above Weisman article.
PMID: 12524257

ATS statement: guidelines for the six-minute walk test. Am J Respir Crit Care Med. 2002; 166:111-7. This statement reviews indications, details factors that influence results, presents a brief step-by-step protocol, outlines safety measures, describes proper patient preparation and
PMID: 12091180

Last Reviewed: June 2017