- A new list of relative contraindications was added.
- Spirometers are now required to meet International Organization for Standardization (ISO) 26782 standards, but with a maximum permissible accuracy error of ±2.5%.
- Device quality assurance procedures were updated.
- Operator training as well as attainment and maintenance of competency were addressed.
- The list of activities that patients should avoid before testing was updated.
- There is a focus on the use of devices that measure both expiration and inspiration.
- Maneuver acceptability and repeatability criteria were updated. The end of forced expiration (EOFE) was redefined.
- Requirements for spirometry systems to provide uniform cues and feedback to the operator were added.
- New withholding times for bronchodilators before bronchodilator responsiveness testing were developed.
- A new grading system for assessment of spirometry quality was developed.
- Standardized operator feedback options that promote synoptic reporting were developed.
- Preliminary findings derived from an international patient survey were presented.