Introduction — This topic includes links to society and government-sponsored guidelines from selected countries and regions around the world. We will update these links periodically; newer versions of some guidelines may be available on each society's website. Some societies may require users to log in to access their guidelines.
The recommendations in the following guidelines may vary from those that appear in UpToDate topic reviews. Readers who are looking for UpToDate topic reviews should use the UpToDate search box to find the relevant content.
Links to related guidelines are provided separately. (See "Society guideline links: Chronic obstructive pulmonary disease" and "Society guideline links: Asthma in adolescents and adults" and "Society guideline links: Asthma in children" and "Society guideline links: Severe asthma in adolescents and adults" and "Society guideline links: Occupational asthma" and "Society guideline links: Exercise-induced bronchoconstriction" and "Society guideline links: Stress testing and cardiopulmonary exercise testing".)
International
●European Respiratory Society (ERS) Global Lung Function Initiative (GLI): Multi-ethnic reference values for spirometry for the 3-95-yr age range – The global lung function equations (2012)
Canada
●Choosing Wisely Canada: Don't diagnose or manage current or chronic or persistent asthma in patients >6 years of age without objective testing such as spirometry or a methacholine challenge (2020)
●Choosing Wisely Canada: Don't initiate long-term maintenance treatments (eg, bronchodilators, inhaled corticosteroids, leukotriene receptor antagonists, or other) in adult patients with suspected COPD/asthma without confirming a diagnosis with objective testing such as spirometry/methacholine challenge (2019)
●Choosing Wisely Canada: Don't initiate medications for asthma (eg, inhalers, leukotriene receptor antagonists, or other) in patients ≥6 years old who have not had confirmation of reversible airflow limitation with spirometry, and in its absence, a positive methacholine or exercise challenge test, or sufficient peak expiratory flow variability (2019)
●Canadian Thoracic Society (CTS): Spirometry in primary care – Position statement (2013)
United States
●American Thoracic Society (ATS) and European Respiratory Society (ERS): Standardization of spirometry, update (2019)
●ATS: Official technical statement on preschool multiple-breath washout testing (2018)
●ATS: Official technical statement on recommendations for a standardized pulmonary function report (2017)
●ERS/ATS: Standards for single-breath carbon monoxide uptake in the lung (2017)
●ATS: Official technical standards on spirometry in the occupational setting (2014)
●ERS/ATS: Official technical standard on field walking tests in chronic respiratory disease (2014)
●Choosing Wisely: Prior to cardiac surgery, there is no need for pulmonary function testing in the absence of respiratory symptoms (2013)
●ERS/ATS: Consensus statement for inert gas washout measurement using multiple- and single-breath tests (2013)
●Choosing Wisely: Don't diagnose or manage asthma without spirometry (2012)
●American Association for Respiratory Care (AARC): Clinical practice guideline on infant/toddler pulmonary function tests – Revision and update (2008)
●ATS/ERS: Official statement on pulmonary function testing in preschool children (2007)
●ATS/ERS: Recommendations for standardized procedures for the online and offline measurement of exhaled lower respiratory nitric oxide and nasal nitric oxide (2005)
●ATS/ERS: Standardisation of lung function testing – General considerations for lung function testing (2005)
●ATS/ERS: Standardisation of lung function testing – Interpretative strategies for lung function tests (2005)
●ATS/ERS: Standardisation of lung function testing – Standardisation of the measurement of lung volumes (2005)
●ATS/ERS: Statement on respiratory muscle testing (2002)
Europe
●American Thoracic Society (ATS) and European Respiratory Society (ERS): Standardization of spirometry, update (2019)
●ERS: Statement on respiratory muscle testing at rest and during exercise (2019)
●ERS: Technical standard on bronchial challenge testing – Pathophysiology and methodology of indirect airway challenge testing (2018)
●ERS/ATS: Standards for single-breath carbon monoxide uptake in the lung (2017)
●ERS: Technical standard on bronchial challenge testing – General considerations and performance of methacholine challenge tests (2017)
●ERS: Technical standard on exhaled biomarkers in lung disease (2017)
●ERS: Technical standard on standardisation and application of the single-breath determination of nitric oxide uptake in the lung (2017)
●ERS/ATS: Official technical standard on field walking tests in chronic respiratory disease (2014)
●ERS/ATS: Consensus statement for inert gas washout measurement using multiple- and single-breath tests (2013)
●ATS/ERS: Official statement on pulmonary function testing in preschool children (2007)
●ERS: Recommendations on the use of exercise testing in clinical practice (2007)
●ATS/ERS: Recommendations for standardized procedures for the online and offline measurement of exhaled lower respiratory nitric oxide and nasal nitric oxide (2005)
●ATS/ERS: Standardisation of lung function testing – General considerations for lung function testing (2005)
●ATS/ERS: Standardisation of lung function testing – Interpretative strategies for lung function tests (2005)
●ATS/ERS: Standardisation of lung function testing – Standardisation of the measurement of lung volumes (2005)
●ATS/ERS: Statement on respiratory muscle testing (2002)
Australia-New Zealand
●Choosing Wisely Australia: Avoid routinely performing preoperative blood investigations, chest X-ray or spirometry prior to surgery, but instead order in response to patient factors, symptoms and signs, disease, or planned surgery (2017)
●Australian and New Zealand Society of Respiratory Science (ANZSRS): Position statement on reference values for spirometry and their use in test interpretation (2016)
Japan
●[In Japanese] Japanese Respiratory Society (JRS): Guideline on intractable asthma diagnosis and treatment (2019)
●[In Japanese] Choosing Wisely Japan: Spirometry test for asthma – Why you need it, if you need it (2016)
