ATS (American Thoracic Society) guidelines are the globally recognised clinical standards that define how respiratory function tests should be performed, interpreted, and reported. For clinical physiology labs, staying aligned with these guidelines is not optional - it directly affects diagnostic accuracy, patient safety, and accreditation outcomes. Rezibase, a cloud-based respiratory and sleep reporting platform built by respiratory scientists, embeds ATS-aligned algorithms directly into its reporting workflows, reducing the burden on labs to manually track and apply evolving standards.

TL;DR

• ATS guidelines set the benchmark for respiratory test performance, interpretation, and reporting worldwide [American Thoracic Society | Clinical Practice Guidelines, Statements…]

• Guidelines are updated periodically, and labs that fail to keep up face clinical risk and accreditation issues

• Manual compliance is error-prone; software-driven alignment is the more reliable and scalable approach

• Rezibase embeds ATS-aligned reporting algorithms and an up-to-date normal values library directly into its platform [Cardiobase]

• Labs can stay compliant without relying on individual scientists to remember every guideline update

About the Author: This article was written by the Rezibase team, a group of experienced respiratory scientists and healthcare technology specialists with over 37 years of collective experience building and supporting clinical physiology lab systems across Australia, New Zealand, the UK, and Ireland [Cardiobase].

What Are ATS Guidelines and Why Do They Matter in Respiratory Reporting?

ATS guidelines are official clinical practice documents published by the American Thoracic Society that establish evidence-based recommendations for the diagnosis, management, and reporting of respiratory conditions [American Thoracic Society | Clinical Practice Guidelines, Statements…]. In the context of pulmonary function testing (PFT), they cover everything from spirometry technique and quality grading to the interpretation of obstruction, restriction, and gas transfer results.

These guidelines matter for several concrete reasons:

• Diagnostic consistency: Without a shared standard, two labs could interpret the same spirometry result differently, leading to different clinical decisions for the same patient.

• Accreditation requirements: Regulatory bodies and hospital accreditation programs expect labs to demonstrate alignment with current best-practice standards.

• Medicolegal accountability: Reports that deviate from published guidelines without documented clinical reasoning can expose labs to liability.

• Research and benchmarking: Guideline-aligned data is comparable across institutions, enabling meaningful audit and research outcomes.

The ATS also provides guideline implementation tools to assist labs in translating recommendations into practical clinical workflows [Guideline Implementation Tools], recognising that publishing a guideline and actually embedding it into daily practice are two very different challenges.

How Often Do ATS Guidelines Change, and What Happens When Labs Fall Behind?

Respiratory guidelines are not static. The ATS regularly updates its clinical practice documents as new evidence emerges, and the changes can be substantive. For example, significant updates to bronchiolitis management guidelines between 2016 and 2025 illustrate how quickly consensus positions can shift within a decade [Summary of key changes in recommendations between the 2016 guideline and 2025 update - PREDICT]. In pulmonary function testing, updates to reference equations, interpretation algorithms, and quality criteria have similarly reshaped what "correct" reporting looks like.

When labs fall behind on guideline updates, the consequences are practical and immediate:

The challenge is not that respiratory scientists are unaware of updates. It is that manually tracking, interpreting, and applying those updates across a whole department's reporting workflow is genuinely difficult, especially in busy public hospital labs with high test volumes.

What Does ATS Guideline Alignment Actually Look Like in Practice?

ATS compliance is not a checkbox. It is a collection of specific, technical requirements embedded in how tests are conducted, graded, and reported. In practical terms, guideline-aligned reporting includes:

• Applying the correct reference equations for the patient's age, sex, height, and ethnicity

• Grading spirometry quality using current ATS acceptability and repeatability criteria

• Interpreting results using the recommended statistical thresholds (such as the lower limit of normal rather than fixed percentage cutoffs)

• Structuring the report to include relevant clinical context, not just raw numbers

• Flagging results that require clinical correlation or further investigation

Each of these steps requires the reporting system to be configured correctly, not just the scientist to be knowledgeable. A scientist working in a system that uses outdated reference values or does not support current grading criteria cannot easily produce a guideline-aligned report, regardless of their expertise.

How Does Rezibase Help Labs Stay Aligned With ATS Guidelines?

Rezibase addresses guideline compliance at the system level, not by relying on individual users to manually apply standards [Cardiobase]. This is the key distinction between a reporting tool and a true clinical reporting platform.

Specific features that support ATS alignment include:

• ATS-aligned reporting algorithms: The doctor-facing reporting interface uses structured algorithms that guide interpretation and report writing according to current ATS recommendations, reducing variability between reporters.

• Normal Values Library: A pre-configured and regularly updated library of industry-standard reference values is built into the platform, so labs are always working from current equations without manual updates.

• AI-powered report writing and structure improvement: The platform supports medical dictation and AI-assisted report writing that helps structure reports consistently, reducing the risk of omissions.

• Magic Import with discrete data extraction: By automatically extracting discrete data from device reports, including flow-volume loops, the platform reduces transcription errors that can compromise data integrity and downstream interpretation.

• Accreditation module: The platform includes tools for managing documents, training records, non-conformances, audits, and quality control to support TSANZ and NATA standards, including ISO 15189 requirements - standards that themselves require alignment with published clinical guidelines.

The result is that guideline compliance becomes a property of the system, not a manual task delegated to each individual scientist or reporting doctor.

Is Switching to a Guideline-Aligned System Complicated?

Transitioning to Rezibase from an existing system is designed to be straightforward. Rezibase supports extensive integration with hospital Patient Administration Systems, Electronic Medical Records, DICOM Modality Worklists, and Electronic Orders Systems, which means existing data and workflows can be connected without starting from scratch.

For labs moving from other respiratory reporting platforms, data migration is handled as part of the onboarding process, with the goal of keeping disruption to a minimum and getting labs up and running quickly. The platform is cloud-based, which removes the need for local server installation or complex IT infrastructure changes.

Rezibase also offers a 30-day free trial with no lock-in contracts, so labs can evaluate the platform against their real workflows before committing.

Frequently Asked Questions

What is the ATS and why do its guidelines matter for respiratory labs?
The American Thoracic Society is a leading international body that publishes evidence-based clinical guidelines for respiratory medicine and testing. Its guidelines are the accepted standard for pulmonary function test performance, interpretation, and reporting worldwide [American Thoracic Society | Clinical Practice Guidelines, Statements…].

Do ATS guidelines apply outside the United States?
Yes. ATS guidelines are adopted as best-practice standards internationally, including in Australia, New Zealand, and the UK, often in conjunction with ERS (European Respiratory Society) joint publications.

How does Rezibase stay up to date with guideline changes?
Rezibase maintains a regularly updated Normal Values Library and updates its reporting algorithms as guidelines evolve, so labs benefit from current standards without needing to manually configure changes.

Can Rezibase integrate with our existing hospital systems?
Yes. Rezibase integrates with Patient Administration Systems, EMRs, DICOM Modality Worklists, Hospital Finance Systems, and Electronic Orders Systems.

Does Rezibase support accreditation requirements beyond ATS guidelines?
Yes. The accreditation module supports TSANZ and NATA standards, including ISO 15189 requirements, covering documents, training, audits, non-conformances, and quality control.

Is Rezibase only for large hospitals?
No. Rezibase serves both public hospital labs and private respiratory and sleep clinics across Australia, New Zealand, the UK, and Ireland.

What respiratory testing does Rezibase support reporting for?
Rezibase supports a comprehensive range of respiratory and sleep reporting, covering the full scope of a clinical physiology lab's output.

About Rezibase

Rezibase is Australia's most advanced cloud-based respiratory and sleep reporting platform, built by respiratory scientists for respiratory scientists [Cardiobase]. Trusted by over 35 sites including NHS institutions in the UK and NSW Health in Australia, Rezibase combines ATS-aligned reporting algorithms, an up-to-date normal values library, vendor-neutral device integration, and a full accreditation management module in a single, hassle-free SaaS solution. With over 37 years of experience in the clinical physiology space and a transparent, no lock-in pricing model, Rezibase is purpose-built to help labs improve patient care, reduce clinical risk, and stay ahead of evolving standards.

Ready to see how Rezibase supports ATS-aligned reporting in your lab? Explore the platform and start your free trial at rezibase.com.