CHEST Guidelines-Is-the-Global-Lung-Function-Initiative-Race-Neutra

Is-the-Global-Lung-Function-Initiative-Race-Neutra

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The Global Lung Function Initiative (GLI) has developed race-neutral spirometry reference equations, termed the 2022-GLI, aimed at improving clinical utility globally for assessing lung function in conditions like COPD and asthma. Traditionally, spirometry reference equations have been tailored to specific ethnic and geographic groups, such as the 2012-GLI which used race and ethnicity as factors. However, these race-specific models are criticized for reflecting social and environmental influences rather than genetic ancestry. Consequently, the new race-neutral 2022-GLI was designed to address this issue. <br /><br />A study by Diao et al. evaluated these new equations against the 2012-GLI. The findings indicated that the 2022-GLI maintains comparable accuracy in predicting clinical outcomes including respiratory conditions and mortality. Notably, the adoption of the 2022-GLI led to reclassification of different ethnic groups regarding disease severity and impairment, which could impact eligibility for disability benefits and occupational assessments.<br /><br />Further analysis by Choi et al., focusing on Northeast Asian COPD patients, aligned the reliability of the 2022-GLI with traditional models although the switch to the 2022-GLI increased the proportion classified with mild COPD. This shift might reduce clinical trial participation among certain patient groups due to trial inclusion criteria typically requiring moderate to severe classifications.<br /><br />Despite these findings, the 2022-GLI's efficacy needs further validation across broader Asian populations and other ethnicities. Limitations include lack of gender diversity within study groups and restriction to COPD diseases, implying potential variability when applied to other conditions. Overall, while not flawless, the 2022-GLI equation is anticipated to see increased application, necessitating ongoing examination of its global impact in clinical and policy contexts.

Keywords

Global Lung Function Initiative

race-neutral spirometry

2022-GLI

lung function

COPD

asthma

ethnic groups

clinical outcomes

disease severity

disability benefits