求翻译：Unfortunately, routine pulmonary function tests on every RA patient have not been established as a cost-effective approach to screening for pulmonary disease [18]. Considering that a number of patients will have abnormalities that do not correlate with clinical disease, we believe that the history and physical remain the vanguards of clinical evaluation until further studies of costeffectiveness are presented [11]. We advocate that each clinic visit include a brief inquiry into the presence of cough or mild dyspnea when climbing a flight of stairs or on an incline, as well as clinical examination for pulmonary crackles or digital clubbing although these are usually only found in advanced disease [19].是什么意思？

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