Almost all of our patients with CF participate in the national CF Foundation (CFF)-sponsored CF Registry. Detailed clinical information is collected through the Registry and published each year in the CFF Annual Data Report and online, from which some of the information is accessible to the public. The Data Report is meant to be one way to compare outcomes at different CF Centers. Also, it is used locally to identify areas that need further improvement. In the recently published 2008 Data Report, the average FEV1 values for patients at our Center ages 6-12 years had decreased significantly from last year. This continues a trend the investigators have seen over the past 5 years, despite no apparent change in the treatment protocols at our Center. Nationally, FEV1 values for patients in this age range have stayed the same. This apparent local decrease was quite troubling to our Center staff and became a recent focus of our Quality Improvement efforts.