Abstract
Background: Spirometry is advocated for adults with obstructive lung disease such as asthma or chronic obstructive lung disease (COPD), for individuals with risk factors such as cigarette smoking, and for patients with chronic respiratory symptoms. This record review study was performed to determine how frequent medical residents order spirometry for the above indications. 
 
 Methods: Outpatient general medical clinic records from 337 patients followed in the medical clinics of a large, teaching hospital in an urban setting were reviewed. Inclusion criteria for review included age > 45 yr and one of the following: 1) a diagnosis of asthma and/or COPD, 2) either current or previous cigarette smoking, 3) one or more of the following chronic respiratory symptoms: dyspnea, cough, sputum production.
 
 Results: The mean (SD) age was 57 + 10 yr. Of this group, only 31% had spirometry or an order for spirometry documented in the outpatient record. 
 
 Conclusion: This finding underscores the under-utilization of spirometry as a diagnostic tool, even in an academic setting.
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