MIR Insights

Meet a new spirometry assistant.

More and more product offerings inundate us with Smart devices that, regardless of their intended use, are synonymous with advanced technology.
Today we even have communications systems mounted on a Smart vase that can send a signal every time that our flowers need to be watered!
Considering this technological evolution, what do I expect when I read that a spirometer is Smart?

The first answer that comes to mind is wireless connectivity. More than 15 years after its introduction, Bluetooth technology ensures very low battery consumption and an immediate connection between communicating devices. The dark days of pairing seem distant!

The second answer is the use of a tablet which increasingly joins, or replaces, the beloved Personal Computer.

In addition, I expect the maximum ease of use so that even our non–specialist medical staff, or paramedics, who work in primary

care facilities will have no difficulty operating the device. Better still if the spirometer is Smart, it will provide assistance when I have a doubt regarding the interpretation of a spirometry, perhaps after a reversibility test to discern between asthma and COPD, or when the manoeuvre was not performed correctly.

There is another quality that would make the device even more Smart: if it is able to avoid calibration procedures without compromising the accuracy of the measurement, and therefore of the diagnosis.

In this article we analyze a new generation spirometer, the Spirobank II Smart edition produced by MIR – Medical International Research (www. spirometry.com). The device has been developed for multiple work environments to satisfy the needs of a pulmonologist as well as those of a facility that performs screening.

Thanks to Bluetooth 4.0 technology the device connects easily to an iPad, the most popular tablet on the market. The App
can be downloaded for free from the Apple Store. The App works effortlessly from the start. Does anyone remember the complicated Bluetooth connections? Forget that. Now, finally the communication is immediate and natural without any required passkey or procedure.


The calculated parameters allow for a complete functional diagnosis and provide slow and forced vital capacity, and bronchodilation testing. To complete the analysis of the respiratory functionality in addition to spirometry, the device can also perform oximetry. The main App view offers a complete picture of all the patient's results. All functions are easily accessible and intuitive.


One of the limitations to the spread of spirometry on a large scale is the technique of execution, due to the necessary compliance of the patient during testing. This is combined with an inherent difficulty of interpretation, not always

easy for non–specialist medical practitioners.

A highly innovative quality of the analyzed device is the presence of an expert system – a kind of virtual assistant – which supports the operator before, during and after the spirometry test. For example,

it checks the execution of the manoeuvre and reports the phases in which the patient has been non compliant.

The structural concept is typical of expert systems and is generally defined as artificial intelligence: understand, classify, formulate judgments, develop and combine concepts in order to provide appropriate responses


The virtual assistant, organized in various sections, has the following key features:

• Incorporates a didactic strategy based on knowledge of the domain of competence through a static guide with recommendations for the execution of the spirometry, the typical clinical cases and the common sources of error

• Identifies in a timely manner the cause of errors through dynamic control of recorded curves (Flow–Volume and Volume– Time)

• Suggests the most convenient way to avoid errors by providing suggestions both for the operator and for the patient

• Interprets the clinical picture on the basis of the results and the morphology of the recorded curves

Another characteristic of the device is the pre–calibrated disposable turbine flow sensor that is inserted and locked to the body of the spirometer with a simple rotation. Indeed the sensor resolves hygienic and calibration issues.


Apps can help us do more. The functionalities built into this App are designed for the essential things we use every day – diagnosis, pdf by email and print – direct and simple as a tap, letting us focus on the patient and changing our software experience.

Last but not least, the data recorded on an iPad on Wi–Fi connection can be transferred in HL7 format to a web service for archiving tasks or for second opinions, and are enabled for EMR access.

The road towards Smart spirometry is open!