Artificial Intelligence for Spirometry Quality Evaluation: A Systematic Review.

Background and Objectives: Spirometry is the most widely used pulmonary function test for diagnosing respiratory diseases. Its progressive incorporation into non-specialized settings, such as primary care, raises challenges for ensuring the reliability of results. In this context, tools based on artificial intelligence (AI) techniques have emerged as promising solutions to support quality control in spirometry. This systematic review aims to synthesize the available evidence on their application in this field. Methods: A systematic search was conducted in PubMed and IEEE Xplore to identify peer-reviewed original studies, published between 2014 and June 2025, that applied AI to spirometry quality control. The search and data extraction followed the PRISMA guidelines. Results: Six studies met the inclusion criteria. Four analyzed the acceptability and usability of the maneuver, and two focused on detecting errors committed during test performance. The most widely used models were convolutional neural networks, used in four studies, whereas two studies employed other conventional machine learning models. Three models reported area under the ROC curve values higher than 0.88. Conclusions: AI-based tools show great potential to assist in spirometry quality control, both in determining acceptability and in detecting errors. However, current studies remain scarce and highly heterogeneous in both objectives and methods. Broader, multicenter research, including validation in non-specialized settings, is required to confirm their clinical utility and facilitate their implementation in clinical practice.